- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,463.60 / $18,969.70 / $25,904.90
| Facility | | $10,463.60 | $18,969.70 | $25,904.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,358.00 / $21,295.00 / $29,127.00
| Facility | | $9,358.00 | $21,295.00 | $29,127.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,049.36 / $17,007.68 / $25,814.35
| Facility | | $10,049.36 | $17,007.68 | $25,814.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,119.41 / $19,119.41 / $23,216.44
| Facility | | $19,119.41 | $19,119.41 | $23,216.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,912.01 / $20,531.14 / $32,222.44
| Facility | | $9,912.01 | $20,531.14 | $32,222.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,445.00 / $18,969.70 / $25,865.00
| Facility | | $10,445.00 | $18,969.70 | $25,865.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,453.65 / $15,664.05 / $24,669.92
| Facility | | $9,453.65 | $15,664.05 | $24,669.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,342.74 / $13,008.39
| Facility | | $2,621.40 | $9,342.74 | $13,008.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $14,625.58 / $26,529.10
| Facility | | $5,404.00 | $14,625.58 | $26,529.10 |