- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,817.30 / $23,236.80 / $32,020.00
| Facility | | $12,817.30 | $23,236.80 | $32,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,155.00 / $25,095.77 / $36,298.64
| Facility | | $12,155.00 | $25,095.77 | $36,298.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,439.22 / $20,833.41 / $30,970.74
| Facility | | $12,439.22 | $20,833.41 | $30,970.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,420.18 / $23,420.18 / $28,438.79
| Facility | | $23,420.18 | $23,420.18 | $28,438.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,059.08 / $23,560.24 / $36,649.16
| Facility | | $13,059.08 | $23,560.24 | $36,649.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,794.50 / $23,236.80 / $31,731.90
| Facility | | $12,794.50 | $23,236.80 | $31,731.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,704.41 / $19,215.98 / $29,961.00
| Facility | | $11,704.41 | $19,215.98 | $29,961.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,600.03 / $16,331.62
| Facility | | $2,621.40 | $11,600.03 | $16,331.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,610.47 / $17,915.49 / $32,496.60
| Facility | | $6,610.47 | $17,915.49 | $32,496.60 |