- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,708.82 / $63,095.73 / $181,970.09
| Facility | | $45,708.82 | $63,095.73 | $181,970.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $53,703.18
| Professional | | $43,651.58 | $43,651.58 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $40,738.03 / $57,543.99
| Facility | | $13,182.57 | $40,738.03 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $51,286.14 / $61,659.50
| Professional | | $40,738.03 | $51,286.14 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $43,651.58 / $50,118.72
| Facility | | $40,738.03 | $43,651.58 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $46,773.51
| Professional | | $43,651.58 | $43,651.58 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,791.08 / $17,378.01 / $22,387.21
| Professional | | $14,791.08 | $17,378.01 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $44,668.36 / $74,131.02
| Facility | | $19,952.62 | $44,668.36 | $74,131.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $107,151.93 / $112,201.85
| Professional | | $30.20 | $107,151.93 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $45,708.82 / $93,325.43
| Facility | | $43,651.58 | $45,708.82 | $93,325.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37,153.52 / $45,708.82 / $47,863.01
| Professional | | $37,153.52 | $45,708.82 | $47,863.01 |