- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,273.73 / $24,273.73 / $24,273.73
| Facility | | $24,273.73 | $24,273.73 | $24,273.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,378.55 / $22,830.80 / $24,273.73
| Professional | | $13,378.55 | $22,830.80 | $24,273.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,825.40 / $28,980.18 / $40,354.07
| Facility | | $24,825.40 | $28,980.18 | $40,354.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,184.14 / $27,531.17 / $28,980.18
| Professional | | $23,184.14 | $27,531.17 | $28,980.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,200.25 / $89,417.19 / $248,348.67
| Facility | | $16,200.25 | $89,417.19 | $248,348.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,597.00 / $35,612.82 / $42,668.19
| Professional | | $33,597.00 | $35,612.82 | $42,668.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,085.92 / $85,791.41 / $195,550.14
| Facility | | $53,085.92 | $85,791.41 | $195,550.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,597.00 / $33,597.00 / $34,572.40
| Professional | | $33,597.00 | $33,597.00 | $34,572.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,600.69 / $28,980.18 / $134,932.92
| Facility | | $8,600.69 | $28,980.18 | $134,932.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,622.87 / $14,470.71 / $29,101.33
| Professional | | $8,622.87 | $14,470.71 | $29,101.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,383.10 / $34,568.35 / $41,482.01
| Facility | | $29,383.10 | $34,568.35 | $41,482.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,622.87 / $14,443.33 / $29,101.33
| Professional | | $8,622.87 | $14,443.33 | $29,101.33 |