- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $52,480.75 / $125,892.54
| Facility | | $43,651.58 | $52,480.75 | $125,892.54 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $54,954.09
| Professional | | $43,651.58 | $43,651.58 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,810.72 / $45,708.82 / $91,201.08
| Facility | | $39,810.72 | $45,708.82 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,708.82 / $51,286.14 / $199,526.23
| Professional | | $45,708.82 | $51,286.14 | $199,526.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53,703.18 / $58,884.37 / $67,608.30
| Professional | | $53,703.18 | $58,884.37 | $67,608.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45,708.82 / $45,708.82 / $45,708.82
| Professional | | $45,708.82 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Professional | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $47,863.01 / $51,286.14
| Professional | | $43,651.58 | $47,863.01 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Professional | | $48,977.88 | $48,977.88 | $48,977.88 |