- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,899.30 / $24,899.30 / $25,164.39
| Facility | | $24,899.30 | $24,899.30 | $25,164.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,993.53 / $24,899.30 / $25,952.62
| Professional | | $22,993.53 | $24,899.30 | $25,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,211.27 / $47,211.27 / $50,138.37
| Facility | | $47,211.27 | $47,211.27 | $50,138.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27,870.24 / $27,870.24 / $34,840.58
| Professional | | $27,870.24 | $27,870.24 | $34,840.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25,311.29 / $25,311.29 / $32,273.33
| Professional | | $25,311.29 | $25,311.29 | $32,273.33 |
- 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 / $31,290.51
| Professional | | $22,842.07 | $22,842.07 | $31,290.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,047.89 / $42,490.14 / $56,653.52
| Professional | | $33,047.89 | $42,490.14 | $56,653.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,917.11 / $29,035.79 / $52,750.80
| Facility | | $13,917.11 | $29,035.79 | $52,750.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34,119.83 / $62,012.25 / $78,638.72
| Professional | | $34,119.83 | $62,012.25 | $78,638.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,537.76 / $35,735.85 / $54,025.00
| Facility | | $23,537.76 | $35,735.85 | $54,025.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24,572.39 / $35,735.85 / $54,025.00
| Professional | | $24,572.39 | $35,735.85 | $54,025.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,557.44 / $23,553.19 / $33,790.06
| Professional | | $21,557.44 | $23,553.19 | $33,790.06 |