- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $22,387.21 / $31,622.78
| Facility | | $12,302.69 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,703.96 / $36,307.81
| Facility | | $17,378.01 | $25,703.96 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,417.38 / $30,199.52
| Facility | | $12,022.64 | $20,417.38 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $28,840.32
| Facility | | $23,442.29 | $23,442.29 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $22,908.68 / $27,542.29
| Facility | | $10,000.00 | $22,908.68 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,197.01 / $36,307.81
| Facility | | $13,803.84 | $18,197.01 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,892.96 / $30,902.95
| Facility | | $12,022.64 | $20,892.96 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $13,803.84 / $21,877.62
| Facility | | $10,471.29 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,218.10 / $28,183.83
| Facility | | $5,370.32 | $16,218.10 | $28,183.83 |