- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $51,286.14 / $91,201.08
| Facility | | $20,417.38 | $51,286.14 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $60,255.96
| Professional | | $43,651.58 | $43,651.58 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $63,095.73 / $95,499.26
| Facility | | $36,307.81 | $63,095.73 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32,359.37 / $45,708.82 / $50,118.72
| Professional | | $32,359.37 | $45,708.82 | $50,118.72 |
- 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 / $60,255.96
| Professional | | $43,651.58 | $43,651.58 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $14,791.08
| Professional | | $14,791.08 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $44,668.36 / $66,069.34
| Facility | | $21,877.62 | $44,668.36 | $66,069.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $58,884.37 / $81,283.05
| Professional | | $0.60 | $58,884.37 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,668.36 / $74,131.02 / $83,176.38
| Facility | | $44,668.36 | $74,131.02 | $83,176.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $45,708.82 / $47,863.01
| Professional | | $43,651.58 | $45,708.82 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223,872.11 / $223,872.11 / $223,872.11
| Facility | | $223,872.11 | $223,872.11 | $223,872.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199,526.23 / $199,526.23 / $199,526.23
| Professional | | $199,526.23 | $199,526.23 | $199,526.23 |