- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $23,988.33 / $33,884.42
| Facility | | $13,803.84 | $23,988.33 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,840.32 / $38,018.94
| Facility | | $15,488.17 | $28,840.32 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $22,387.21 / $35,481.34
| Facility | | $12,882.50 | $22,387.21 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $30,902.95
| Facility | | $25,703.96 | $25,703.96 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $24,547.09 / $30,902.95
| Facility | | $10,715.19 | $24,547.09 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $23,442.29 / $31,622.78
| Facility | | $16,218.10 | $23,442.29 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $23,988.33 / $33,884.42
| Facility | | $13,182.57 | $23,988.33 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,715.19 / $12,302.69
| Facility | | $9,549.93 | $10,715.19 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $17,378.01 / $30,902.95
| Facility | | $5,370.32 | $17,378.01 | $30,902.95 |