- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,261.50 / $31,640.20 / $43,207.50
| Facility | | $18,261.50 | $31,640.20 | $43,207.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,380.00 / $29,405.90 / $40,009.00
| Facility | | $14,380.00 | $29,405.90 | $40,009.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,768.03 / $28,367.63 / $43,056.55
| Facility | | $15,768.03 | $28,367.63 | $43,056.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,889.87 / $31,889.87 / $38,723.42
| Facility | | $31,889.87 | $31,889.87 | $38,723.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,226.28 / $33,226.28 / $57,241.35
| Facility | | $33,226.28 | $33,226.28 | $57,241.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,452.50 / $30,426.00 / $42,758.50
| Facility | | $17,452.50 | $30,426.00 | $42,758.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,628.00 / $26,126.55 / $41,448.83
| Facility | | $15,628.00 | $26,126.55 | $41,448.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $15,964.56 / $22,853.59
| Facility | | $2,621.40 | $15,964.56 | $22,853.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,001.08 / $24,394.46 / $44,248.70
| Facility | | $9,001.08 | $24,394.46 | $44,248.70 |