- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,138.27 / $10,138.27 / $10,246.20
| Facility | | $10,138.27 | $10,138.27 | $10,246.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,426.14 / $10,138.27 / $10,900.66
| Professional | | $9,426.14 | $10,138.27 | $10,900.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,223.07 / $19,223.07 / $20,414.90
| Facility | | $19,223.07 | $19,223.07 | $20,414.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,694.54 / $10,694.54 / $13,652.51
| Professional | | $10,694.54 | $10,694.54 | $13,652.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,118.98 / $11,118.98 / $13,140.77
| Professional | | $11,118.98 | $11,118.98 | $13,140.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,562.99 / $12,562.99 / $12,562.99
| Facility | | $12,562.99 | $12,562.99 | $12,562.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,170.98 / $9,170.98 / $12,562.99
| Professional | | $9,170.98 | $9,170.98 | $12,562.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,456.15 / $17,300.75 / $23,067.68
| Professional | | $13,456.15 | $17,300.75 | $23,067.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,638.05 / $11,822.53 / $21,478.60
| Facility | | $5,638.05 | $11,822.53 | $21,478.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,147.00 / $25,249.60 / $32,019.42
| Professional | | $10,147.00 | $25,249.60 | $32,019.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,110.48 / $14,431.80 / $21,014.06
| Facility | | $10,110.48 | $14,431.80 | $21,014.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,110.48 / $14,431.80 / $21,014.06
| Professional | | $10,110.48 | $14,431.80 | $21,014.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,733.27 / $9,590.17 / $13,758.33
| Professional | | $8,733.27 | $9,590.17 | $13,758.33 |