- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $22,387.21 / $31,622.78
| Facility | | $12,589.25 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,908.68 / $37,153.52
| Facility | | $14,125.38 | $22,908.68 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $20,892.96 / $33,113.11
| Facility | | $11,220.18 | $20,892.96 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $28,840.32
| Facility | | $23,988.33 | $23,988.33 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $22,908.68 / $28,840.32
| Facility | | $10,471.29 | $22,908.68 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $31,622.78 / $37,153.52
| Facility | | $31,622.78 | $31,622.78 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $21,379.62 / $30,902.95
| Facility | | $12,302.69 | $21,379.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $9,332.54 / $15,848.93
| Facility | | $7,943.28 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,218.10 / $28,183.83
| Facility | | $5,370.32 | $16,218.10 | $28,183.83 |