- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,571.41 / $15,571.41 / $81,610.60
| Facility | | $15,571.41 | $15,571.41 | $81,610.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,499.54 / $15,571.41 / $81,610.60
| Professional | | $12,499.54 | $15,571.41 | $81,610.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,824.54 / $42,976.29 / $89,786.73
| Facility | | $11,824.54 | $42,976.29 | $89,786.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,519.19 / $17,411.83 / $26,951.57
| Professional | | $14,519.19 | $17,411.83 | $26,951.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.00 / $33,487.51 / $59,799.14
| Facility | | $97.00 | $33,487.51 | $59,799.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $37,530.08 / $87,420.17
| Professional | | $100.00 | $37,530.08 | $87,420.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,200.25 / $16,200.25 / $22,876.27
| Facility | | $16,200.25 | $16,200.25 | $22,876.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,826.18 / $11,826.18 / $18,997.30
| Professional | | $11,826.18 | $11,826.18 | $18,997.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,119.69 / $18,143.63 / $31,114.07
| Professional | | $15,119.69 | $18,143.63 | $31,114.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,971.31 / $19,799.86 / $42,993.99
| Professional | | $16,971.31 | $19,799.86 | $42,993.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,686.70 / $134,932.92 / $134,932.92
| Facility | | $48,686.70 | $134,932.92 | $134,932.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145,801.04 / $145,801.04 / $213,102.83
| Professional | | $145,801.04 | $145,801.04 | $213,102.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59,725.74 / $59,725.74 / $59,725.74
| Professional | | $59,725.74 | $59,725.74 | $59,725.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,350.18 / $25,006.91 / $29,134.51
| Facility | | $8,350.18 | $25,006.91 | $29,134.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,826.18 / $16,200.25 / $26,922.59
| Professional | | $11,826.18 | $16,200.25 | $26,922.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53,387.88 / $53,387.88 / $53,387.88
| Professional | | $53,387.88 | $53,387.88 | $53,387.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,119.69 / $22,628.42 / $22,679.54
| Professional | | $15,119.69 | $22,628.42 | $22,679.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,383.10 / $34,568.35 / $34,568.35
| Facility | | $29,383.10 | $34,568.35 | $34,568.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,175.06 / $13,985.47 / $26,844.46
| Professional | | $12,175.06 | $13,985.47 | $26,844.46 |