- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $18,620.87 / $26,915.35
| Facility | | $10,715.19 | $18,620.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $18,620.87 / $30,902.95
| Facility | | $10,232.93 | $18,620.87 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $17,378.01 / $27,542.29
| Facility | | $9,549.93 | $17,378.01 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $24,547.09
| Facility | | $19,952.62 | $19,952.62 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $19,054.61 / $23,988.33
| Facility | | $8,511.38 | $19,054.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $22,387.21
| Facility | | $16,218.10 | $16,218.10 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,378.01 / $25,703.96
| Facility | | $10,232.93 | $17,378.01 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $8,511.38 / $14,125.38
| Facility | | $7,244.36 | $8,511.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $13,803.84 / $23,988.33
| Facility | | $5,248.07 | $13,803.84 | $23,988.33 |