- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,714.66 / $18,714.66 / $72,425.70
| Facility | | $18,714.66 | $18,714.66 | $72,425.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,791.62 / $19,815.53 / $25,041.32
| Professional | | $16,791.62 | $19,815.53 | $25,041.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31,910.34 / $41,907.21 / $41,907.21
| Professional | | $31,910.34 | $41,907.21 | $41,907.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,391.12 / $30,391.12 / $43,145.97
| Facility | | $30,391.12 | $30,391.12 | $43,145.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,185.52 / $22,185.52 / $37,780.12
| Professional | | $22,185.52 | $22,185.52 | $37,780.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39,694.29 / $43,145.97 / $81,977.34
| Professional | | $39,694.29 | $43,145.97 | $81,977.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,714.66 / $18,714.66 / $72,425.70
| Facility | | $18,714.66 | $18,714.66 | $72,425.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,333.15 / $19,815.53 / $29,182.43
| Professional | | $16,333.15 | $19,815.53 | $29,182.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53,495.70 / $61,520.00 / $85,005.30
| Professional | | $53,495.70 | $61,520.00 | $85,005.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,391.12 / $30,391.12 / $43,145.97
| Facility | | $30,391.12 | $30,391.12 | $43,145.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,185.52 / $22,185.52 / $54,464.63
| Professional | | $22,185.52 | $22,185.52 | $54,464.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,025.41 / $20,025.41 / $39,887.92
| Facility | | $20,025.41 | $20,025.41 | $39,887.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,025.41 / $39,887.92 / $41,067.00
| Professional | | $20,025.41 | $39,887.92 | $41,067.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19,560.65 / $25,144.33 / $37,792.22
| Professional | | $19,560.65 | $25,144.33 | $37,792.22 |