- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,917.13 / $20,539.56 / $37,344.60
| Facility | | $16,917.13 | $20,539.56 | $37,344.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,917.13 / $20,539.56 / $26,888.15
| Professional | | $16,917.13 | $20,539.56 | $26,888.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,235.19 / $40,019.89 / $78,470.38
| Facility | | $39,235.19 | $40,019.89 | $78,470.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,157.64 / $54,000.00 / $65,880.00
| Professional | | $4,157.64 | $54,000.00 | $65,880.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,241.78 / $45,241.78 / $45,241.78
| Facility | | $45,241.78 | $45,241.78 | $45,241.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31,019.05 / $31,019.05 / $31,019.05
| Professional | | $31,019.05 | $31,019.05 | $31,019.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $1,196.41 / $88,279.18
| Facility | | $319.00 | $1,196.41 | $88,279.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,148.76 / $29,469.32 / $71,486.52
| Professional | | $23,148.76 | $29,469.32 | $71,486.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32,185.11 / $34,196.68 / $34,355.71
| Professional | | $32,185.11 | $34,196.68 | $34,355.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $39,235.19 / $45,241.78
| Facility | | $555.00 | $39,235.19 | $45,241.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,008.49 / $31,019.05 / $70,685.96
| Professional | | $28,008.49 | $31,019.05 | $70,685.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,742.28 / $21,530.40 / $37,828.21
| Professional | | $13,742.28 | $21,530.40 | $37,828.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,185.11 / $32,185.11 / $32,185.11
| Facility | | $32,185.11 | $32,185.11 | $32,185.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32,185.11 / $32,185.11 / $34,196.68
| Professional | | $32,185.11 | $32,185.11 | $34,196.68 |