- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,097.50 / $21,789.50 / $33,293.00
| Facility | | $12,097.50 | $21,789.50 | $33,293.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,186.00 / $32,158.88 / $43,415.09
| Facility | | $12,186.00 | $32,158.88 | $43,415.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,567.52 / $20,261.66 / $29,405.18
| Facility | | $11,567.52 | $20,261.66 | $29,405.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,778.97 / $21,778.97 / $26,445.90
| Facility | | $21,778.97 | $21,778.97 | $26,445.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,250.07 / $21,368.60 / $29,527.22
| Facility | | $12,250.07 | $21,368.60 | $29,527.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,919.10 / $21,608.50 / $33,293.00
| Facility | | $11,919.10 | $21,608.50 | $33,293.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,884.20 / $18,847.00 / $28,247.20
| Facility | | $10,884.20 | $18,847.00 | $28,247.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,630.92 / $14,892.29
| Facility | | $2,621.40 | $10,630.92 | $14,892.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,147.23 / $16,660.03 / $30,219.35
| Facility | | $6,147.23 | $16,660.03 | $30,219.35 |