- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,424.06 / $39,890.30 / $56,848.10
| Facility | | $28,424.06 | $39,890.30 | $56,848.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $34,108.90
| Professional | | $28,424.06 | $28,424.06 | $34,108.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,577.01 / $69,098.89 / $142,120.29
| Facility | | $23,577.01 | $69,098.89 | $142,120.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $119,518.82
| Professional | | $28,424.06 | $28,424.06 | $119,518.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,470.59 / $34,904.75 / $67,819.81
| Facility | | $30,470.59 | $34,904.75 | $67,819.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,070.53 / $28,424.06 / $28,424.06
| Facility | | $27,070.53 | $28,424.06 | $28,424.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $28,424.06
| Professional | | $28,424.06 | $28,424.06 | $28,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,909.00 / $9,239.00 / $44,910.01
| Facility | | $1,909.00 | $9,239.00 | $44,910.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $28,424.06
| Professional | | $28,424.06 | $28,424.06 | $28,424.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $32,898.01
| Professional | | $28,424.06 | $28,424.06 | $32,898.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,550.97 / $41,550.97 / $41,550.97
| Facility | | $41,550.97 | $41,550.97 | $41,550.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,809.36 / $142,120.29 / $142,120.29
| Facility | | $37,809.36 | $142,120.29 | $142,120.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $30,129.50 / $119,518.82
| Professional | | $28,424.06 | $30,129.50 | $119,518.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,424.06 / $35,766.28
| Professional | | $28,424.06 | $28,424.06 | $35,766.28 |