- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65,094.44 / $66,721.80 / $73,625.25
| Facility | | $65,094.44 | $66,721.80 | $73,625.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65,094.44 / $66,721.80 / $69,162.84
| Professional | | $65,094.44 | $66,721.80 | $69,162.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,899.25 / $137,501.51 / $272,676.55
| Facility | | $52,899.25 | $137,501.51 | $272,676.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,162.84 / $69,162.84 / $69,162.84
| Facility | | $69,162.84 | $69,162.84 | $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
- $77,299.64 / $284,122.75 / $284,122.75
| Facility | | $77,299.64 | $284,122.75 | $284,122.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281,672.84 / $304,629.20 / $350,237.97
| Professional | | $281,672.84 | $304,629.20 | $350,237.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67,535.48 / $80,165.58 / $163,562.97
| Facility | | $67,535.48 | $80,165.58 | $163,562.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,765.57 / $67,765.57 / $73,939.13
| Professional | | $67,765.57 | $67,765.57 | $73,939.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67,535.48 / $81,368.05 / $110,538.50
| Facility | | $67,535.48 | $81,368.05 | $110,538.50 |
- 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 / $67,806.71
| Professional | | $67,806.71 | $67,806.71 | $67,806.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.00 / $73,939.13 / $99,817.83
| Professional | | $750.00 | $73,939.13 | $99,817.83 |