- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $24,547.09 / $24,547.09
| Facility | | $24,547.09 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,877.62 / $24,547.09 / $169,824.37
| Professional | | $21,877.62 | $24,547.09 | $169,824.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,884.42 / $37,153.52 / $38,018.94
| Professional | | $33,884.42 | $37,153.52 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30,902.95 / $44,668.36 / $81,283.05
| Professional | | $30,902.95 | $44,668.36 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $42,657.95 / $181,970.09
| Facility | | $24,547.09 | $42,657.95 | $181,970.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $33,884.42
| Professional | | $14,791.08 | $20,417.38 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $95,499.26
| Professional | | $42,657.95 | $42,657.95 | $95,499.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81,283.05 / $95,499.26 / $95,499.26
| Professional | | $81,283.05 | $95,499.26 | $95,499.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $25,118.86 / $38,018.94
| Facility | | $16,595.87 | $25,118.86 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $33,884.42
| Professional | | $14,791.08 | $20,417.38 | $33,884.42 |