- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,300.35 / $19,474.16 / $19,720.58
| Professional | | $12,300.35 | $19,474.16 | $19,720.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,802.86 / $53,758.97 / $63,644.33
| Facility | | $39,802.86 | $53,758.97 | $63,644.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,270.92 / $15,270.92 / $24,879.38
| Professional | | $15,270.92 | $15,270.92 | $24,879.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.07 / $16,524.00 / $16,524.00
| Facility | | $350.07 | $16,524.00 | $16,524.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,062.52 / $16,524.00 / $16,524.00
| Professional | | $12,062.52 | $16,524.00 | $16,524.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,363.14 / $17,143.81 / $23,407.84
| Professional | | $9,363.14 | $17,143.81 | $23,407.84 |