- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,560.40 / $97,694.80 / $148,639.54
| Facility | | $45,560.40 | $97,694.80 | $148,639.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,020.65 / $45,470.86 / $58,317.30
| Professional | | $45,020.65 | $45,470.86 | $58,317.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,622.30 / $72,483.25 / $112,551.63
| Facility | | $48,622.30 | $72,483.25 | $112,551.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,020.65 / $50,423.12 / $74,959.38
| Professional | | $45,020.65 | $50,423.12 | $74,959.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,020.65 / $45,020.65 / $67,672.57
| Facility | | $45,020.65 | $45,020.65 | $67,672.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,020.65 / $45,020.65 / $60,777.88
| Professional | | $45,020.65 | $45,020.65 | $60,777.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,472.31 / $45,020.65 / $49,742.71
| Facility | | $42,472.31 | $45,020.65 | $49,742.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,020.65 / $45,020.65 / $60,217.94
| Professional | | $45,020.65 | $45,020.65 | $60,217.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,472.31 / $45,020.65 / $50,000.00
| Facility | | $42,472.31 | $45,020.65 | $50,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,020.65 / $45,020.65 / $63,708.47
| Professional | | $45,020.65 | $45,020.65 | $63,708.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,212.04 / $51,993.84 / $65,200.28
| Professional | | $45,212.04 | $51,993.84 | $65,200.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42,769.62 / $45,020.65 / $54,474.99
| Professional | | $42,769.62 | $45,020.65 | $54,474.99 |