- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53,630.37 / $55,272.32 / $102,806.52
| Professional | | $53,630.37 | $55,272.32 | $102,806.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $55,272.32 / $55,272.32
| Professional | | $55,272.32 | $55,272.32 | $55,272.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55,945.97 / $102,806.52 / $144,048.13
| Facility | | $55,945.97 | $102,806.52 | $144,048.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $55,272.32 / $124,362.72
| Professional | | $55,272.32 | $55,272.32 | $124,362.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,828.67 / $108,948.00 / $171,204.00
| Facility | | $83,828.67 | $108,948.00 | $171,204.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77,820.00 / $93,384.00 / $93,384.00
| Professional | | $77,820.00 | $93,384.00 | $93,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55,272.32 / $102,806.52 / $147,013.32
| Facility | | $55,272.32 | $102,806.52 | $147,013.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $66,018.28 / $93,384.00
| Professional | | $55,272.32 | $66,018.28 | $93,384.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $82,908.48 / $82,908.48
| Professional | | $55,272.32 | $82,908.48 | $82,908.48 |