- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $67,608.30 / $125,892.54
| Facility | | $46,773.51 | $67,608.30 | $125,892.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $58,884.37
| Professional | | $43,651.58 | $43,651.58 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,480.75 / $109,647.82 / $177,827.94
| Facility | | $52,480.75 | $109,647.82 | $177,827.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $50,118.72 / $67,608.30
| Facility | | $43,651.58 | $50,118.72 | $67,608.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $44,668.36
| Professional | | $43,651.58 | $43,651.58 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,708.82 / $47,863.01 / $67,608.30
| Professional | | $45,708.82 | $47,863.01 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $43,651.58 / $67,608.30
| Facility | | $17,782.79 | $43,651.58 | $67,608.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $56,234.13
| Professional | | $40,738.03 | $40,738.03 | $56,234.13 |
- 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 / $45,708.82
| Professional | | $43,651.58 | $43,651.58 | $45,708.82 |