- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,917.83 / $14,917.83 / $15,076.65
| Facility | | $14,917.83 | $14,917.83 | $15,076.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,776.05 / $14,917.83 / $16,550.27
| Professional | | $13,776.05 | $14,917.83 | $16,550.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,285.52 / $28,285.52 / $30,039.22
| Facility | | $28,285.52 | $28,285.52 | $30,039.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,411.83 / $17,411.83 / $21,766.52
| Professional | | $17,411.83 | $17,411.83 | $21,766.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,755.45 / $16,755.45 / $19,335.81
| Professional | | $16,755.45 | $16,755.45 | $19,335.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,200.25 / $16,200.25 / $16,200.25
| Facility | | $16,200.25 | $16,200.25 | $16,200.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,826.18 / $11,826.18 / $16,200.25
| Professional | | $11,826.18 | $11,826.18 | $16,200.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19,799.86 / $25,456.97 / $33,942.62
| Professional | | $19,799.86 | $25,456.97 | $33,942.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,350.18 / $17,396.11 / $31,736.79
| Facility | | $8,350.18 | $17,396.11 | $31,736.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,442.14 / $37,153.17 / $47,114.53
| Professional | | $20,442.14 | $37,153.17 | $47,114.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,174.71 / $21,346.84 / $32,103.28
| Facility | | $14,174.71 | $21,346.84 | $32,103.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,174.71 / $21,346.84 / $32,103.28
| Professional | | $14,174.71 | $21,346.84 | $32,103.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,568.35 / $34,568.35 / $41,482.01
| Facility | | $34,568.35 | $34,568.35 | $41,482.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,934.33 / $14,111.33 / $20,244.52
| Professional | | $12,934.33 | $14,111.33 | $20,244.52 |