- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,308.10 / $85,265.80 / $166,503.00
| Facility | | $62,308.10 | $85,265.80 | $166,503.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,138.39 / $71,167.10 / $71,167.10
| Professional | | $67,138.39 | $71,167.10 | $71,167.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,255.43 / $69,492.78 / $86,865.99
| Facility | | $57,255.43 | $69,492.78 | $86,865.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69,492.78 / $69,492.78 / $69,492.78
| Professional | | $69,492.78 | $69,492.78 | $69,492.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71,167.10 / $71,167.10 / $71,167.10
| Facility | | $71,167.10 | $71,167.10 | $71,167.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71,167.10 / $71,167.10 / $71,167.10
| Professional | | $71,167.10 | $71,167.10 | $71,167.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,302.47 / $82,740.53 / $126,178.93
| Facility | | $41,302.47 | $82,740.53 | $126,178.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67,138.39 / $100,708.00 / $166,503.00
| Facility | | $67,138.39 | $100,708.00 | $166,503.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,138.39 / $71,167.10 / $133,605.00
| Professional | | $67,138.39 | $71,167.10 | $133,605.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71,167.10 / $71,167.10 / $71,167.10
| Facility | | $71,167.10 | $71,167.10 | $71,167.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71,167.10 / $71,167.10 / $71,167.10
| Professional | | $71,167.10 | $71,167.10 | $71,167.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69,772.00 / $69,772.00 / $83,726.39
| Professional | | $69,772.00 | $69,772.00 | $83,726.39 |