- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,737.30 / $28,530.60 / $38,961.10
| Facility | | $15,737.30 | $28,530.60 | $38,961.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,418.44 / $27,418.44 / $28,528.93
| Facility | | $27,418.44 | $27,418.44 | $28,528.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,534.00 / $27,903.72 / $40,036.55
| Facility | | $8,534.00 | $27,903.72 | $40,036.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,044.62 / $13,044.62 / $27,512.81
| Facility | | $13,044.62 | $13,044.62 | $27,512.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,708.00 / $3,708.00 / $3,708.00
| Facility | | $3,708.00 | $3,708.00 | $3,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,371.70 / $24,372.69 / $41,096.01
| Facility | | $11,371.70 | $24,372.69 | $41,096.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,709.40 / $27,403.30 / $38,556.19
| Facility | | $15,709.40 | $27,403.30 | $38,556.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,044.62 / $13,044.62 / $27,512.81
| Facility | | $13,044.62 | $13,044.62 | $27,512.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,905.80 / $19,792.66
| Facility | | $2,621.40 | $13,905.80 | $19,792.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,313.71 / $21,996.99 / $39,899.97
| Facility | | $7,313.71 | $21,996.99 | $39,899.97 |