- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,618.54 / $23,618.54 / $54,024.00
| Facility | | $23,618.54 | $23,618.54 | $54,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,020.02 / $23,618.54 / $32,527.80
| Professional | | $23,020.02 | $23,618.54 | $32,527.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,420.14 / $53,207.84 / $137,856.67
| Facility | | $45,420.14 | $53,207.84 | $137,856.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24,233.94 / $27,015.99 / $62,881.98
| Professional | | $24,233.94 | $27,015.99 | $62,881.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,278.07 / $48,370.76 / $65,300.53
| Facility | | $36,278.07 | $48,370.76 | $65,300.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31,611.31 / $43,769.51 / $103,571.47
| Professional | | $31,611.31 | $43,769.51 | $103,571.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,290.51 / $31,290.51 / $56,991.55
| Facility | | $31,290.51 | $31,290.51 | $56,991.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,842.07 / $22,842.07 / $39,973.62
| Professional | | $22,842.07 | $22,842.07 | $39,973.62 |
- 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 / $31,290.51
| Professional | | $22,842.07 | $31,290.51 | $31,290.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,087.76 / $24,131.64 / $33,219.35
| Professional | | $16,087.76 | $24,131.64 | $33,219.35 |