- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,411.50 / $18,597.00 / $25,395.80
| Facility | | $10,411.50 | $18,597.00 | $25,395.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,002.00 / $17,887.00 / $26,688.00
| Facility | | $9,002.00 | $17,887.00 | $26,688.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,367.31 / $17,437.88 / $25,432.00
| Facility | | $9,367.31 | $17,437.88 | $25,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,743.73 / $18,743.73 / $22,760.24
| Facility | | $18,743.73 | $18,743.73 | $22,760.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,258.00 / $17,862.20 / $25,131.90
| Facility | | $10,258.00 | $17,862.20 | $25,131.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,688.50 / $15,379.00 / $23,864.00
| Facility | | $8,688.50 | $15,379.00 | $23,864.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,224.86 / $11,390.12
| Facility | | $2,621.40 | $8,224.86 | $11,390.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $14,338.19 / $26,007.80
| Facility | | $5,404.00 | $14,338.19 | $26,007.80 |