- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,933.26 / $26,933.26 / $26,933.26
| Facility | | $26,933.26 | $26,933.26 | $26,933.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,847.48 / $26,933.26 / $32,882.44
| Professional | | $20,847.48 | $26,933.26 | $32,882.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,163.36 / $35,961.43 / $46,515.16
| Facility | | $34,163.36 | $35,961.43 | $46,515.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31,010.10 / $36,824.50 / $38,762.62
| Professional | | $31,010.10 | $36,824.50 | $38,762.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82,321.64 / $138,083.85 / $332,179.39
| Facility | | $82,321.64 | $138,083.85 | $332,179.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44,937.75 / $47,634.02 / $57,070.94
| Professional | | $44,937.75 | $47,634.02 | $57,070.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71,005.21 / $114,750.52 / $261,558.58
| Facility | | $71,005.21 | $114,750.52 | $261,558.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44,937.75 / $44,937.75 / $46,242.40
| Professional | | $44,937.75 | $44,937.75 | $46,242.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,706.21 / $38,762.62 / $182,487.33
| Facility | | $27,706.21 | $38,762.62 | $182,487.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,249.48 / $20,613.43 / $46,393.04
| Professional | | $13,249.48 | $20,613.43 | $46,393.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,249.48 / $20,365.15 / $44,693.79
| Professional | | $13,249.48 | $20,365.15 | $44,693.79 |