- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110,545.00 / $110,545.00 / $110,545.00
| Facility | | $110,545.00 | $110,545.00 | $110,545.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.31 / $55,272.32 / $66,326.78
| Professional | | $55,272.31 | $55,272.32 | $66,326.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,740.55 / $174,517.54 / $305,800.06
| Facility | | $46,740.55 | $174,517.54 | $305,800.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44,942.84 / $51,363.25 / $57,783.65
| Professional | | $44,942.84 | $51,363.25 | $57,783.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,000.00 / $55,272.32 / $55,272.32
| Facility | | $50,000.00 | $55,272.32 | $55,272.32 |
- 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
- $54,547.21 / $64,617.60 / $95,533.38
| Facility | | $54,547.21 | $64,617.60 | $95,533.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,945.97 / $55,945.97 / $77,820.00
| Professional | | $55,945.97 | $55,945.97 | $77,820.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $55,272.32 / $58,588.66
| Professional | | $55,272.32 | $55,272.32 | $58,588.66 |