- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,245.07 / $21,756.03 / $36,196.87
| Professional | | $21,245.07 | $21,756.03 | $36,196.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,394.66 / $44,775.69 / $80,952.60
| Facility | | $12,394.66 | $44,775.69 | $80,952.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30,986.65 / $41,315.53 / $56,292.41
| Professional | | $30,986.65 | $41,315.53 | $56,292.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,290.51 / $31,290.51 / $31,290.51
| Facility | | $31,290.51 | $31,290.51 | $31,290.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,842.07 / $22,842.07 / $56,076.38
| Professional | | $22,842.07 | $22,842.07 | $56,076.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,917.11 / $30,380.45 / $225,247.51
| Facility | | $13,917.11 | $30,380.45 | $225,247.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19,483.93 / $21,557.44 / $33,219.35
| Professional | | $19,483.93 | $21,557.44 | $33,219.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19,483.93 / $21,557.44 / $32,473.24
| Professional | | $19,483.93 | $21,557.44 | $32,473.24 |