- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,054.61 / $28,183.83
| Facility | | $10,715.19 | $19,054.61 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $12,022.64 / $12,022.64
| Facility | | $12,022.64 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $24,547.09 / $38,018.94
| Facility | | $12,302.69 | $24,547.09 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,782.79 / $28,183.83
| Facility | | $10,232.93 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $24,547.09
| Facility | | $20,417.38 | $20,417.38 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $19,952.62 / $24,547.09
| Facility | | $8,709.64 | $19,952.62 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $18,197.01 / $42,657.95
| Facility | | $15,848.93 | $18,197.01 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $17,782.79 / $26,915.35
| Facility | | $10,471.29 | $17,782.79 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,232.93 / $14,454.40
| Facility | | $8,912.51 | $10,232.93 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $14,454.40 / $24,547.09
| Facility | | $5,370.32 | $14,454.40 | $24,547.09 |