- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $75,857.76 / $173,780.08
| Facility | | $43,651.58 | $75,857.76 | $173,780.08 |
- 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
- $43,651.58 / $114,815.36 / $223,872.11
| Facility | | $43,651.58 | $114,815.36 | $223,872.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $43,651.58 / $199,526.23
| Professional | | $40,738.03 | $43,651.58 | $199,526.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $85,113.80
| Facility | | $43,651.58 | $43,651.58 | $85,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $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
- $1,995.26 / $43,651.58 / $70,794.58
| Facility | | $1,995.26 | $43,651.58 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $47,863.01
| Professional | | $40,738.03 | $40,738.03 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75,857.76 / $75,857.76 / $75,857.76
| Facility | | $75,857.76 | $75,857.76 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44,668.36 / $44,668.36 / $44,668.36
| Professional | | $44,668.36 | $44,668.36 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $114,815.36 / $223,872.11
| Facility | | $43,651.58 | $114,815.36 | $223,872.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $43,651.58 / $199,526.23
| Professional | | $40,738.03 | $43,651.58 | $199,526.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $45,708.82 / $97,723.72
| Facility | | $43,651.58 | $45,708.82 | $97,723.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $51,286.14
| Professional | | $43,651.58 | $43,651.58 | $51,286.14 |