- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $85,113.80 / $162,181.01
| Facility | | $43,651.58 | $85,113.80 | $162,181.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $52,480.75
| Professional | | $43,651.58 | $43,651.58 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $87,096.36 / $158,489.32
| Facility | | $33,884.42 | $87,096.36 | $158,489.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50,118.72 / $50,118.72 / $50,118.72
| Professional | | $50,118.72 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $43,651.58 / $43,651.58
| Facility | | $79.43 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $43,651.58 / $43,651.58
| Facility | | $40,738.03 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Professional | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223,872.11 / $223,872.11 / $223,872.11
| Facility | | $223,872.11 | $223,872.11 | $223,872.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199,526.23 / $199,526.23 / $199,526.23
| Professional | | $199,526.23 | $199,526.23 | $199,526.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $75,857.76
| Facility | | $43,651.58 | $43,651.58 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $47,863.01
| Professional | | $43,651.58 | $43,651.58 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41,686.94 / $45,708.82 / $52,480.75
| Professional | | $41,686.94 | $45,708.82 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,183.83 / $32,359.37 / $97,723.72
| Professional | | $28,183.83 | $32,359.37 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $43,651.58 / $72,443.60
| Facility | | $22,908.68 | $43,651.58 | $72,443.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $54,954.09
| Professional | | $40,738.03 | $40,738.03 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $44,668.36
| Facility | | $43,651.58 | $43,651.58 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43,651.58 / $45,708.82 / $47,863.01
| Professional | | $43,651.58 | $45,708.82 | $47,863.01 |
- 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 |