- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,821.91 / $26,106.15 / $69,214.77
| Facility | | $15,821.91 | $26,106.15 | $69,214.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,821.91 / $15,821.91 / $18,228.47
| Professional | | $15,821.91 | $15,821.91 | $18,228.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,713.25 / $53,058.07 / $98,838.23
| Facility | | $39,713.25 | $53,058.07 | $98,838.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,401.37 / $42,401.37 / $42,401.37
| Facility | | $42,401.37 | $42,401.37 | $42,401.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,087.50 / $16,087.50 / $16,087.50
| Professional | | $16,087.50 | $16,087.50 | $16,087.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,763.21 / $52,160.11 / $151,045.73
| Facility | | $17,763.21 | $52,160.11 | $151,045.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,616.93 / $43,630.00 / $79,999.20
| Facility | | $22,616.93 | $43,630.00 | $79,999.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,279.26 / $51,089.58 / $97,728.60
| Facility | | $37,279.26 | $51,089.58 | $97,728.60 |