- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,749.20 / $22,772.50 / $31,097.90
| Facility | | $12,749.20 | $22,772.50 | $31,097.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,617.00 / $24,195.22 / $33,388.00
| Facility | | $11,617.00 | $24,195.22 | $33,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,063.91 / $21,353.16 / $30,989.24
| Facility | | $12,063.91 | $21,353.16 | $30,989.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,952.21 / $22,952.21 / $27,870.54
| Facility | | $22,952.21 | $22,952.21 | $27,870.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,307.89 / $22,623.97 / $27,973.02
| Facility | | $15,307.89 | $22,623.97 | $27,973.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,561.20 / $22,772.50 / $31,097.90
| Facility | | $12,561.20 | $22,772.50 | $31,097.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,348.78 / $18,832.00 / $29,040.57
| Facility | | $11,348.78 | $18,832.00 | $29,040.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,224.85 / $14,319.90
| Facility | | $2,621.40 | $10,224.85 | $14,319.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,478.38 / $17,418.21 / $31,847.27
| Facility | | $6,478.38 | $17,418.21 | $31,847.27 |