- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,847.48 / $28,804.37 / $29,944.56
| Professional | | $20,847.48 | $28,804.37 | $29,944.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $76,046.73 / $88,607.04
| Facility | | $0.02 | $76,046.73 | $88,607.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29,867.55 / $33,849.89 / $61,446.25
| Professional | | $29,867.55 | $33,849.89 | $61,446.25 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $16,561.84 / $22,742.70 / $34,870.75
| Professional | | $16,561.84 | $22,742.70 | $34,870.75 |