- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,521.60 / $24,513.70 / $33,475.60
| Facility | | $13,521.60 | $24,513.70 | $33,475.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,559.00 / $25,232.52 / $36,834.19
| Facility | | $13,559.00 | $25,232.52 | $36,834.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,347.56 / $22,985.80 / $33,358.65
| Facility | | $12,347.56 | $22,985.80 | $33,358.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,707.11 / $24,707.11 / $30,001.49
| Facility | | $24,707.11 | $24,707.11 | $30,001.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,493.24 / $31,346.28 / $41,268.33
| Facility | | $25,493.24 | $31,346.28 | $41,268.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,497.60 / $23,990.40 / $33,475.60
| Facility | | $13,497.60 | $23,990.40 | $33,475.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,452.78 / $20,271.89 / $31,816.04
| Facility | | $11,452.78 | $20,271.89 | $31,816.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,880.42 / $16,773.97
| Facility | | $2,621.40 | $11,880.42 | $16,773.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,852.26 / $20,341.00 / $34,282.28
| Facility | | $6,852.26 | $20,341.00 | $34,282.28 |