- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67,608.30 / $107,151.93 / $208,929.61
| Facility | | $67,608.30 | $107,151.93 | $208,929.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,608.30 / $69,183.10 / $83,176.38
| Professional | | $67,608.30 | $69,183.10 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,018.94 / $85,113.80 / $173,780.08
| Facility | | $38,018.94 | $85,113.80 | $173,780.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31,622.78 / $69,183.10 / $81,283.05
| Professional | | $31,622.78 | $69,183.10 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70,794.58 / $70,794.58 / $95,499.26
| Facility | | $70,794.58 | $70,794.58 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,113.11 / $41,686.94 / $70,794.58
| Professional | | $33,113.11 | $41,686.94 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79,432.82 / $104,712.85 / $154,881.66
| Facility | | $79,432.82 | $104,712.85 | $154,881.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66,069.34 / $69,183.10 / $74,131.02
| Professional | | $66,069.34 | $69,183.10 | $74,131.02 |