- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,143.80 / $25,641.80 / $35,016.10
| Facility | | $14,143.80 | $25,641.80 | $35,016.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,407.00 / $25,758.71 / $38,943.87
| Facility | | $12,407.00 | $25,758.71 | $38,943.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,583.91 / $22,989.61 / $33,924.49
| Facility | | $13,583.91 | $22,989.61 | $33,924.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,844.10 / $25,844.10 / $31,382.12
| Facility | | $25,844.10 | $25,844.10 | $31,382.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,017.93 / $22,442.86 / $33,193.01
| Facility | | $11,017.93 | $22,442.86 | $33,193.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,756.40 / $24,908.00 / $34,652.19
| Facility | | $13,756.40 | $24,908.00 | $34,652.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,778.68 / $20,996.17 / $33,051.43
| Facility | | $12,778.68 | $20,996.17 | $33,051.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,850.25 / $18,223.30
| Facility | | $2,621.40 | $12,850.25 | $18,223.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,294.63 / $19,769.68 / $35,859.90
| Facility | | $7,294.63 | $19,769.68 | $35,859.90 |