- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,726.00 / $83,726.00 / $83,726.00
| Facility | | $83,726.00 | $83,726.00 | $83,726.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66,980.80 / $69,492.58 / $83,726.00
| Professional | | $66,980.80 | $69,492.58 | $83,726.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,231.16 / $68,017.69 / $108,870.21
| Facility | | $48,231.16 | $68,017.69 | $108,870.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,725.76 / $104,499.92 / $127,222.14
| Facility | | $60,725.76 | $104,499.92 | $127,222.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,136.46 / $38,495.16 / $41,666.64
| Professional | | $33,136.46 | $38,495.16 | $41,666.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,379.66 / $95,363.01 / $119,684.95
| Facility | | $52,379.66 | $95,363.01 | $119,684.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32,808.37 / $32,808.37 / $44,619.39
| Professional | | $32,808.37 | $32,808.37 | $44,619.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,424.18 / $34,116.31 / $106,789.61
| Facility | | $20,424.18 | $34,116.31 | $106,789.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65,822.00 / $65,822.00 / $73,523.17
| Professional | | $65,822.00 | $65,822.00 | $73,523.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66,234.05 / $69,772.00 / $88,131.46
| Professional | | $66,234.05 | $69,772.00 | $88,131.46 |