- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $18,620.87 / $26,302.68
| Facility | | $10,715.19 | $18,620.87 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $22,387.21 / $30,199.52
| Facility | | $13,182.57 | $22,387.21 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $17,378.01 / $27,542.29
| Facility | | $10,000.00 | $17,378.01 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $23,988.33
| Facility | | $19,952.62 | $19,952.62 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $19,054.61 / $23,442.29
| Facility | | $8,912.51 | $19,054.61 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,848.93 / $25,118.86
| Facility | | $8,912.51 | $15,848.93 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $18,620.87 / $25,703.96
| Facility | | $10,232.93 | $18,620.87 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $8,511.38 / $9,772.37
| Facility | | $7,585.78 | $8,511.38 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $13,489.63 / $23,988.33
| Facility | | $4,786.30 | $13,489.63 | $23,988.33 |