- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $22,908.68 / $32,359.37
| Facility | | $10,471.29 | $22,908.68 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,791.08 / $24,547.09
| Professional | | $12,022.64 | $14,791.08 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $57,543.99
| Facility | | $28,840.32 | $28,840.32 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,378.01 / $18,197.01 / $45,708.82
| Professional | | $17,378.01 | $18,197.01 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $23,442.29 / $23,442.29
| Facility | | $21,877.62 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $23,442.29
| Professional | | $23,442.29 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $45,708.82 / $50,118.72
| Facility | | $16,218.10 | $45,708.82 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $28,840.32
| Professional | | $11,748.98 | $11,748.98 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $47,863.01 / $112,201.85
| Facility | | $28,840.32 | $47,863.01 | $112,201.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,782.79 / $31,622.78 / $56,234.13
| Professional | | $17,782.79 | $31,622.78 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,982.44 / $18,197.01 / $20,417.38
| Professional | | $16,982.44 | $18,197.01 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $22,908.68
| Professional | | $22,908.68 | $22,908.68 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19,054.61 / $27,542.29 / $27,542.29
| Professional | | $19,054.61 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $30,199.52 / $35,481.34
| Facility | | $10,715.19 | $30,199.52 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,135.61 / $23,988.33
| Professional | | $9,549.93 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,982.44 / $21,877.62
| Facility | | $16,218.10 | $16,982.44 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $18,197.01
| Professional | | $16,982.44 | $16,982.44 | $18,197.01 |