- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65,094.44 / $80,165.60 / $80,165.60
| Facility | | $65,094.44 | $80,165.60 | $80,165.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65,094.44 / $65,094.44 / $65,094.44
| Professional | | $65,094.44 | $65,094.44 | $65,094.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,575.62 / $90,778.63 / $177,011.74
| Facility | | $69,575.62 | $90,778.63 | $177,011.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57,737.95 / $60,169.02 / $60,776.80
| Professional | | $57,737.95 | $60,169.02 | $60,776.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51,927.75 / $64,909.69 / $121,296.01
| Professional | | $51,927.75 | $64,909.69 | $121,296.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,824.55 / $67,691.12 / $284,122.75
| Facility | | $56,824.55 | $67,691.12 | $284,122.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66,804.64 / $67,806.71 / $81,368.05
| Professional | | $66,804.64 | $67,806.71 | $81,368.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,633.63 / $85,236.83 / $121,296.01
| Facility | | $57,633.63 | $85,236.83 | $121,296.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57,633.63 / $84,037.67 / $130,334.08
| Professional | | $57,633.63 | $84,037.67 | $130,334.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64,416.37 / $67,806.71 / $74,587.38
| Professional | | $64,416.37 | $67,806.71 | $74,587.38 |