- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,315.40 / $21,997.60 / $30,039.60
| Facility | | $12,315.40 | $21,997.60 | $30,039.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,489.00 / $22,489.30 / $31,846.75
| Facility | | $11,489.00 | $22,489.30 | $31,846.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,653.38 / $20,626.52 / $29,934.68
| Facility | | $11,653.38 | $20,626.52 | $29,934.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,171.15 / $22,171.15 / $26,922.11
| Facility | | $22,171.15 | $22,171.15 | $26,922.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,200.93 / $22,997.43 / $25,415.42
| Facility | | $21,200.93 | $22,997.43 | $25,415.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,133.70 / $21,528.00 / $30,039.60
| Facility | | $12,133.70 | $21,528.00 | $30,039.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,080.19 / $18,191.16 / $28,052.33
| Facility | | $11,080.19 | $18,191.16 | $28,052.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,667.17 / $13,490.76
| Facility | | $2,621.40 | $9,667.17 | $13,490.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,257.92 / $16,825.48 / $30,763.51
| Facility | | $6,257.92 | $16,825.48 | $30,763.51 |