- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $22,908.68 / $39,810.72
| Facility | | $16,982.44 | $22,908.68 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,982.44 / $23,442.29 / $38,904.51
| Professional | | $16,982.44 | $23,442.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $89,125.09
| Facility | | $17,782.79 | $24,547.09 | $89,125.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,988.33 / $51,286.14
| Professional | | $23,442.29 | $23,988.33 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $177,827.94
| Facility | | $30,199.52 | $30,199.52 | $177,827.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $67,608.30
| Professional | | $22,387.21 | $22,387.21 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $30,199.52 / $53,703.18
| Facility | | $19,498.45 | $30,199.52 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,877.62 / $33,113.11
| Professional | | $15,488.17 | $21,877.62 | $33,113.11 |