- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,233.30 / $25,463.00 / $35,245.30
| Facility | | $14,233.30 | $25,463.00 | $35,245.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,287.00 / $27,131.00 / $38,485.00
| Facility | | $13,287.00 | $27,131.00 | $38,485.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,201.52 / $23,531.04 / $36,865.30
| Facility | | $13,201.52 | $23,531.04 | $36,865.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,855.42 / $24,855.42 / $30,181.58
| Facility | | $24,855.42 | $24,855.42 | $30,181.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,288.93 / $27,688.18 / $30,845.97
| Facility | | $17,288.93 | $27,688.18 | $30,845.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,602.80 / $25,519.10 / $33,951.00
| Facility | | $13,602.80 | $25,519.10 | $33,951.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,421.67 / $20,393.57 / $33,931.46
| Facility | | $12,421.67 | $20,393.57 | $33,931.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,545.78 / $16,246.04
| Facility | | $2,621.40 | $11,545.78 | $16,246.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $19,813.81 / $32,605.57
| Facility | | $5,404.00 | $19,813.81 | $32,605.57 |