- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $47,863.01
| Facility | | $15,488.17 | $21,379.62 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $33,884.42
| Professional | | $15,488.17 | $21,379.62 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $40,738.03
| Facility | | $38,904.51 | $38,904.51 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,073.80 / $53,703.18 / $53,703.18
| Professional | | $4,073.80 | $53,703.18 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26,302.68 / $26,302.68 / $26,302.68
| Professional | | $26,302.68 | $26,302.68 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30,902.95 / $30,902.95 / $30,902.95
| Professional | | $30,902.95 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,840.32 / $38,904.51 / $50,118.72
| Professional | | $28,840.32 | $38,904.51 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $27,542.29 / $43,651.58
| Facility | | $18,620.87 | $27,542.29 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $47,863.01
| Professional | | $28,183.83 | $28,183.83 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $33,884.42 / $57,543.99
| Facility | | $24,547.09 | $33,884.42 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24,547.09 / $33,884.42 / $57,543.99
| Professional | | $24,547.09 | $33,884.42 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $19,952.62 / $52,480.75
| Facility | | $14,791.08 | $19,952.62 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $33,113.11
| Professional | | $19,952.62 | $19,952.62 | $33,113.11 |