- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $41,686.94 / $61,659.50
| Facility | | $3,548.13 | $41,686.94 | $61,659.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,442.29 / $28,183.83 / $35,481.34
| Professional | | $23,442.29 | $28,183.83 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,018.94 / $57,543.99 / $69,183.10
| Facility | | $38,018.94 | $57,543.99 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,417.38 / $38,904.51 / $42,657.95
| Professional | | $20,417.38 | $38,904.51 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $40,738.03
| Facility | | $28,183.83 | $28,183.83 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $33,113.11
| Professional | | $28,183.83 | $28,183.83 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $2,089.30
| Professional | | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $28,183.83 / $38,904.51
| Facility | | $2,754.23 | $28,183.83 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Professional | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $38,018.94 / $45,708.82
| Professional | | $0.60 | $38,018.94 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $44,668.36 / $50,118.72
| Facility | | $28,183.83 | $44,668.36 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26,915.35 / $30,199.52 / $31,622.78
| Professional | | $26,915.35 | $30,199.52 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141,253.75 / $141,253.75 / $141,253.75
| Facility | | $141,253.75 | $141,253.75 | $141,253.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120,226.44 / $120,226.44 / $120,226.44
| Professional | | $120,226.44 | $120,226.44 | $120,226.44 |