- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,124.70 / $21,981.20 / $30,017.30
| Facility | | $12,124.70 | $21,981.20 | $30,017.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,144.00 / $23,720.10 / $34,450.04
| Facility | | $11,144.00 | $23,720.10 | $34,450.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,767.06 / $19,707.68 / $30,244.53
| Facility | | $11,767.06 | $19,707.68 | $30,244.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,154.67 / $22,154.67 / $26,902.10
| Facility | | $22,154.67 | $22,154.67 | $26,902.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,644.88 / $23,644.88 / $36,452.37
| Facility | | $23,644.88 | $23,644.88 | $36,452.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,103.20 / $21,112.70 / $30,017.30
| Facility | | $12,103.20 | $21,112.70 | $30,017.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,071.96 / $18,150.75 / $29,839.00
| Facility | | $11,071.96 | $18,150.75 | $29,839.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,606.37 / $16,341.62
| Facility | | $2,621.40 | $11,606.37 | $16,341.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,253.27 / $16,947.41 / $30,740.65
| Facility | | $6,253.27 | $16,947.41 | $30,740.65 |