- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,703.90 / $24,682.80 / $36,119.90
| Facility | | $13,703.90 | $24,682.80 | $36,119.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,134.00 / $28,630.54 / $41,528.08
| Facility | | $13,134.00 | $28,630.54 | $41,528.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,967.25 / $22,952.08 / $33,679.51
| Facility | | $12,967.25 | $22,952.08 | $33,679.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,670.86 / $24,670.86 / $29,957.47
| Facility | | $24,670.86 | $24,670.86 | $29,957.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,070.44 / $32,910.35 / $36,166.72
| Facility | | $15,070.44 | $32,910.35 | $36,166.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,501.80 / $24,682.80 / $35,672.30
| Facility | | $13,501.80 | $24,682.80 | $35,672.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,198.57 / $20,242.14 / $33,679.51
| Facility | | $12,198.57 | $20,242.14 | $33,679.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,744.85 / $18,066.59
| Facility | | $2,621.40 | $12,744.85 | $18,066.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,963.48 / $20,614.95 / $34,231.98
| Facility | | $6,963.48 | $20,614.95 | $34,231.98 |