- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $74,131.02 / $131,825.67
| Facility | | $43,651.58 | $74,131.02 | $131,825.67 |
- 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
- $39,810.72 / $46,773.51 / $58,884.37
| Facility | | $39,810.72 | $46,773.51 | $58,884.37 |
- 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 / $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 / $44,668.36
| Professional | | $43,651.58 | $43,651.58 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $60,255.96 / $60,255.96
| Professional | | $40,738.03 | $60,255.96 | $60,255.96 |
- 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
- $14,791.08 / $43,651.58 / $74,131.02
| Professional | | $14,791.08 | $43,651.58 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,286.14 / $51,286.14 / $51,286.14
| Facility | | $51,286.14 | $51,286.14 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $74,131.02 / $131,825.67
| Facility | | $43,651.58 | $74,131.02 | $131,825.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $74,131.02
| Professional | | $43,651.58 | $43,651.58 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81,283.05 / $81,283.05 / $81,283.05
| Facility | | $81,283.05 | $81,283.05 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $30,902.95 / $97,723.72
| Professional | | $0.60 | $30,902.95 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $50,118.72 / $52,480.75
| Facility | | $43,651.58 | $50,118.72 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $50,118.72 / $52,480.75
| Professional | | $43,651.58 | $50,118.72 | $52,480.75 |
- 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 / $45,708.82 / $53,703.18
| Professional | | $43,651.58 | $45,708.82 | $53,703.18 |