- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,424.10 / $26,724.10 / $36,494.10
| Facility | | $15,424.10 | $26,724.10 | $36,494.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,391.00 / $23,536.58 / $36,515.51
| Facility | | $12,391.00 | $23,536.58 | $36,515.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,157.27 / $24,746.21 / $35,356.40
| Facility | | $14,157.27 | $24,746.21 | $35,356.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,934.94 / $26,934.94 / $32,706.71
| Facility | | $26,934.94 | $26,934.94 | $32,706.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,369.64 / $37,369.64 / $46,283.92
| Facility | | $37,369.64 | $37,369.64 | $46,283.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,740.80 / $25,002.80 / $36,114.90
| Facility | | $14,740.80 | $25,002.80 | $36,114.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,318.05 / $22,099.79 / $34,113.76
| Facility | | $13,318.05 | $22,099.79 | $34,113.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,690.28 / $17,985.45
| Facility | | $2,621.40 | $12,690.28 | $17,985.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,470.12 / $20,604.13 / $37,373.49
| Facility | | $7,470.12 | $20,604.13 | $37,373.49 |