- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,716.79 / $23,786.54 / $32,971.91
| Facility | | $23,716.79 | $23,786.54 | $32,971.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,424.06 / $28,708.30 / $35,530.07
| Professional | | $28,424.06 | $28,708.30 | $35,530.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,667.42 / $37,699.30 / $41,116.57
| Facility | | $31,667.42 | $37,699.30 | $41,116.57 |
- 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
- $60.00 / $28,424.06 / $36,382.79
| Professional | | $60.00 | $28,424.06 | $36,382.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,441.69 / $54,570.02 / $78,343.09
| Facility | | $39,441.69 | $54,570.02 | $78,343.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31,266.47 / $38,526.54 / $40,552.61
| Professional | | $31,266.47 | $38,526.54 | $40,552.61 |
- 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 |