- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,196.87 / $36,196.87 / $73,461.20
| Facility | | $36,196.87 | $36,196.87 | $73,461.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,756.03 / $36,196.87 / $36,196.87
| Professional | | $21,756.03 | $36,196.87 | $36,196.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,304.01 / $72,139.67 / $88,841.97
| Facility | | $44,304.01 | $72,139.67 | $88,841.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,858.15 / $36,474.58 / $40,122.05
| Professional | | $33,858.15 | $36,474.58 | $40,122.05 |
- 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 / $31,290.51 / $56,076.38
| Professional | | $22,842.07 | $31,290.51 | $56,076.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,917.11 / $36,196.87 / $54,227.81
| Facility | | $13,917.11 | $36,196.87 | $54,227.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34,119.83 / $34,119.83 / $34,119.83
| Professional | | $34,119.83 | $34,119.83 | $34,119.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56,653.50 / $56,653.50 / $87,107.40
| Professional | | $56,653.50 | $56,653.50 | $87,107.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,640.81 / $24,262.36 / $35,180.42
| Professional | | $18,640.81 | $24,262.36 | $35,180.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81,262.88 / $225,247.51 / $225,247.51
| Facility | | $81,262.88 | $225,247.51 | $225,247.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243,527.58 / $354,084.53 / $354,084.53
| Professional | | $243,527.58 | $354,084.53 | $354,084.53 |