- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,143.95 / $64,132.50 / $69,162.84
| Facility | | $56,143.95 | $64,132.50 | $69,162.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56,143.95 / $67,535.48 / $69,162.84
| Professional | | $56,143.95 | $67,535.48 | $69,162.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,459.64 / $45,459.64 / $56,824.55
| Facility | | $45,459.64 | $45,459.64 | $56,824.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61,770.36 / $67,806.71 / $67,806.71
| Professional | | $61,770.36 | $67,806.71 | $67,806.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,832.34 / $56,832.34 / $56,832.34
| Facility | | $56,832.34 | $56,832.34 | $56,832.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56,832.34 / $56,832.34 / $56,832.34
| Professional | | $56,832.34 | $56,832.34 | $56,832.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,387.76 / $60,139.40 / $69,162.84
| Facility | | $58,387.76 | $60,139.40 | $69,162.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69,162.84 / $69,162.84 / $69,162.84
| Professional | | $69,162.84 | $69,162.84 | $69,162.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,162.84 / $69,162.84 / $112,043.80
| Facility | | $69,162.84 | $69,162.84 | $112,043.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58,788.41 / $69,162.84 / $69,162.84
| Professional | | $58,788.41 | $69,162.84 | $69,162.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,162.84 / $71,875.11 / $71,875.11
| Facility | | $69,162.84 | $71,875.11 | $71,875.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69,162.84 / $71,875.11 / $71,875.11
| Professional | | $69,162.84 | $71,875.11 | $71,875.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $60,139.40 / $69,162.84
| Facility | | $597.00 | $60,139.40 | $69,162.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69,162.84 / $69,162.84 / $69,162.84
| Professional | | $69,162.84 | $69,162.84 | $69,162.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,806.71 / $67,806.71 / $81,368.05
| Professional | | $67,806.71 | $67,806.71 | $81,368.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,787.81 / $69,162.84 / $69,162.84
| Facility | | $20,787.81 | $69,162.84 | $69,162.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32,130.00 / $69,162.84 / $71,875.11
| Professional | | $32,130.00 | $69,162.84 | $71,875.11 |