- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,379.20 / $42,384.80 / $57,880.20
| Facility | | $23,379.20 | $42,384.80 | $57,880.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,946.00 / $42,268.80 / $60,153.97
| Facility | | $20,946.00 | $42,268.80 | $60,153.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,802.14 / $35,776.50 / $54,649.90
| Facility | | $19,802.14 | $35,776.50 | $54,649.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,719.22 / $42,719.22 / $51,873.33
| Facility | | $42,719.22 | $42,719.22 | $51,873.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,604.95 / $45,295.36 / $103,894.42
| Facility | | $20,604.95 | $45,295.36 | $103,894.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,337.70 / $40,710.00 / $57,278.70
| Facility | | $23,337.70 | $40,710.00 | $57,278.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,802.14 / $34,705.80 / $54,051.03
| Facility | | $19,802.14 | $34,705.80 | $54,051.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $19,709.18 / $28,381.94
| Facility | | $2,621.40 | $19,709.18 | $28,381.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,847.73 / $32,678.46 / $59,274.92
| Facility | | $11,847.73 | $32,678.46 | $59,274.92 |