- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,956.20 / $23,488.60 / $32,075.80
| Facility | | $12,956.20 | $23,488.60 | $32,075.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,629.00 / $24,197.04 / $35,366.47
| Facility | | $11,629.00 | $24,197.04 | $35,366.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,574.00 / $21,750.20 / $30,698.80
| Facility | | $12,574.00 | $21,750.20 | $30,698.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,673.94 / $23,673.94 / $28,746.93
| Facility | | $23,673.94 | $23,673.94 | $28,746.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,084.68 / $19,579.96 / $30,245.54
| Facility | | $9,084.68 | $19,579.96 | $30,245.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,933.20 / $23,488.60 / $32,075.80
| Facility | | $12,933.20 | $23,488.60 | $32,075.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,831.22 / $19,395.45 / $29,953.76
| Facility | | $11,831.22 | $19,395.45 | $29,953.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,507.74 / $16,186.02
| Facility | | $2,621.40 | $11,507.74 | $16,186.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,786.00 / $18,236.03 / $30,206.62
| Facility | | $3,786.00 | $18,236.03 | $30,206.62 |