- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,178.20 / $32,178.20 / $62,532.90
| Facility | | $32,178.20 | $32,178.20 | $62,532.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $51,660.50
| Professional | | $28,424.06 | $28,424.06 | $51,660.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27,581.29 / $28,424.06 / $35,191.69
| Professional | | $27,581.29 | $28,424.06 | $35,191.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,819.60 / $28,424.06 / $45,000.00
| Professional | | $2,819.60 | $28,424.06 | $45,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,364.31 / $30,129.50 / $48,036.66
| Facility | | $8,364.31 | $30,129.50 | $48,036.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $31,266.47 / $119,518.82
| Professional | | $28,424.06 | $31,266.47 | $119,518.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,391.65 / $40,605.80 / $50,273.85
| Facility | | $17,391.65 | $40,605.80 | $50,273.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,277.75 / $32,484.64 / $42,636.09
| Professional | | $7,277.75 | $32,484.64 | $42,636.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,482.90 / $56,326.66 / $59,375.53
| Professional | | $9,482.90 | $56,326.66 | $59,375.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,992.54 / $33,824.62
| Professional | | $28,424.06 | $28,992.54 | $33,824.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,105.57 / $31,105.57 / $31,105.57
| Facility | | $31,105.57 | $31,105.57 | $31,105.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24,573.40 / $31,105.57 / $31,105.57
| Professional | | $24,573.40 | $31,105.57 | $31,105.57 |