- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,293.40 / $21,958.30 / $29,986.00
| Facility | | $12,293.40 | $21,958.30 | $29,986.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,377.00 / $20,038.54 / $28,692.40
| Facility | | $10,377.00 | $20,038.54 | $28,692.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,060.43 / $20,589.72 / $29,881.29
| Facility | | $11,060.43 | $20,589.72 | $29,881.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,131.60 / $22,131.60 / $26,874.09
| Facility | | $22,131.60 | $22,131.60 | $26,874.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,293.36 / $18,498.49 / $23,014.10
| Facility | | $8,293.36 | $18,498.49 | $23,014.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,112.10 / $20,913.00 / $29,674.50
| Facility | | $12,112.10 | $20,913.00 | $29,674.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,903.00 / $18,158.71 / $28,002.29
| Facility | | $10,903.00 | $18,158.71 | $28,002.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,801.73 / $13,690.82
| Facility | | $2,621.40 | $9,801.73 | $13,690.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,246.76 / $16,795.47 / $30,708.64
| Facility | | $6,246.76 | $16,795.47 | $30,708.64 |