- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,914.40 / $24,853.80 / $33,940.00
| Facility | | $13,914.40 | $24,853.80 | $33,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,809.00 / $28,310.31 / $38,538.82
| Facility | | $13,809.00 | $28,310.31 | $38,538.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,166.45 / $23,304.67 / $33,821.41
| Facility | | $13,166.45 | $23,304.67 | $33,821.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,049.86 / $25,049.86 / $30,417.68
| Facility | | $25,049.86 | $25,049.86 | $30,417.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,076.52 / $24,790.76 / $35,833.15
| Facility | | $22,076.52 | $24,790.76 | $35,833.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,709.20 / $24,853.80 / $33,940.00
| Facility | | $13,709.20 | $24,853.80 | $33,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,385.97 / $20,553.09 / $32,197.59
| Facility | | $12,385.97 | $20,553.09 | $32,197.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,010.75 / $16,975.15
| Facility | | $2,621.40 | $12,010.75 | $16,975.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,070.45 / $19,162.12 / $34,757.85
| Facility | | $7,070.45 | $19,162.12 | $34,757.85 |