- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,391.70 / $27,492.50 / $37,543.40
| Facility | | $15,391.70 | $27,492.50 | $37,543.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,116.00 / $27,598.36 / $42,970.00
| Facility | | $14,116.00 | $27,598.36 | $42,970.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,564.34 / $24,648.89 / $36,634.93
| Facility | | $14,564.34 | $24,648.89 | $36,634.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,709.40 / $27,709.40 / $33,647.12
| Facility | | $27,709.40 | $27,709.40 | $33,647.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,680.68 / $25,174.45 / $41,729.74
| Facility | | $8,680.68 | $25,174.45 | $41,729.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,164.70 / $26,406.20 / $37,153.30
| Facility | | $15,164.70 | $26,406.20 | $37,153.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,700.99 / $22,701.60 / $35,448.12
| Facility | | $13,700.99 | $22,701.60 | $35,448.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,584.35 / $19,314.74
| Facility | | $2,621.40 | $13,584.35 | $19,314.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,684.91 / $21,196.57 / $38,448.10
| Facility | | $7,684.91 | $21,196.57 | $38,448.10 |