- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $50,118.72
| Facility | | $43,651.58 | $43,651.58 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $66,069.34
| Professional | | $43,651.58 | $43,651.58 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $47,863.01 / $89,125.09
| Facility | | $20,417.38 | $47,863.01 | $89,125.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47,863.01 / $47,863.01 / $51,286.14
| Professional | | $47,863.01 | $47,863.01 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $43,651.58 / $43,651.58
| Facility | | $40,738.03 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Professional | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $45,708.82 / $61,659.50
| Facility | | $34,673.69 | $45,708.82 | $61,659.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39,810.72 / $45,708.82 / $53,703.18
| Professional | | $39,810.72 | $45,708.82 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $33,113.11 / $38,904.51
| Professional | | $30.20 | $33,113.11 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $66,069.34 / $109,647.82
| Facility | | $46,773.51 | $66,069.34 | $109,647.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $51,286.14 / $51,286.14
| Professional | | $43,651.58 | $51,286.14 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38,018.94 / $40,738.03 / $42,657.95
| Professional | | $38,018.94 | $40,738.03 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $45,708.82
| Professional | | $43,651.58 | $43,651.58 | $45,708.82 |