- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,183.83 / $40,738.03
| Facility | | $15,488.17 | $28,183.83 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $28,840.32 / $52,480.75
| Facility | | $12,302.69 | $28,840.32 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $24,547.09 / $35,481.34
| Facility | | $13,803.84 | $24,547.09 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $29,512.09 / $36,307.81
| Facility | | $29,512.09 | $29,512.09 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $28,183.83 / $34,673.69
| Facility | | $14,791.08 | $28,183.83 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $27,542.29 / $37,153.52
| Facility | | $15,848.93 | $27,542.29 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $25,703.96 / $39,810.72
| Facility | | $15,135.61 | $25,703.96 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,022.64 / $19,952.62
| Facility | | $10,000.00 | $12,022.64 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $20,417.38 / $35,481.34
| Facility | | $5,370.32 | $20,417.38 | $35,481.34 |