- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,510.70 / $22,681.00 / $30,972.90
| Facility | | $12,510.70 | $22,681.00 | $30,972.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,893.00 / $20,946.00 / $30,377.76
| Facility | | $10,893.00 | $20,946.00 | $30,377.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,015.41 / $21,267.31 / $30,864.65
| Facility | | $12,015.41 | $21,267.31 | $30,864.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,859.93 / $22,859.93 / $27,758.49
| Facility | | $22,859.93 | $22,859.93 | $27,758.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,047.31 / $37,745.47 / $40,405.96
| Facility | | $29,047.31 | $37,745.47 | $40,405.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,488.50 / $22,196.80 / $30,972.90
| Facility | | $12,488.50 | $22,196.80 | $30,972.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,303.15 / $18,756.30 / $28,923.82
| Facility | | $11,303.15 | $18,756.30 | $28,923.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,807.85 / $15,140.14
| Facility | | $2,621.40 | $10,807.85 | $15,140.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,339.96 / $17,486.91 / $31,719.23
| Facility | | $6,339.96 | $17,486.91 | $31,719.23 |