- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,118.48 / $71,167.10 / $145,019.00
| Facility | | $12,118.48 | $71,167.10 | $145,019.00 |
- 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
- $31,905.54 / $67,320.69 / $108,478.84
| Facility | | $31,905.54 | $67,320.69 | $108,478.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66,980.80 / $66,980.80 / $66,980.80
| Professional | | $66,980.80 | $66,980.80 | $66,980.80 |
- 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
- $83,726.25 / $83,726.25 / $83,726.25
| Professional | | $83,726.25 | $83,726.25 | $83,726.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,891.65 / $83,726.00 / $108,387.49
| Facility | | $26,891.65 | $83,726.00 | $108,387.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34,448.00 / $34,448.00 / $34,448.00
| Professional | | $34,448.00 | $34,448.00 | $34,448.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,283.39 / $69,772.00 / $89,308.16
| Facility | | $66,283.39 | $69,772.00 | $89,308.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66,283.39 / $69,772.00 / $89,308.16
| Professional | | $66,283.39 | $69,772.00 | $89,308.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,678.84 / $69,772.00 / $83,726.25
| Professional | | $67,678.84 | $69,772.00 | $83,726.25 |