- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,577.60 / $24,252.10 / $33,118.40
| Facility | | $13,577.60 | $24,252.10 | $33,118.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,219.00 / $24,938.83 / $38,646.16
| Facility | | $14,219.00 | $24,938.83 | $38,646.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,847.73 / $22,740.52 / $33,369.08
| Facility | | $12,847.73 | $22,740.52 | $33,369.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,443.47 / $24,443.47 / $29,681.35
| Facility | | $24,443.47 | $24,443.47 | $29,681.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,044.08 / $44,370.91 / $47,702.99
| Facility | | $40,044.08 | $44,370.91 | $47,702.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,377.30 / $23,734.40 / $33,118.40
| Facility | | $13,377.30 | $23,734.40 | $33,118.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,086.14 / $20,055.57 / $33,369.08
| Facility | | $12,086.14 | $20,055.57 | $33,369.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,913.80 / $18,317.77
| Facility | | $2,621.40 | $12,913.80 | $18,317.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,899.29 / $18,698.25 / $33,916.46
| Facility | | $6,899.29 | $18,698.25 | $33,916.46 |