- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77,381.25 / $77,820.00 / $94,714.65
| Facility | | $77,381.25 | $77,820.00 | $94,714.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $56,377.77 / $77,820.00
| Professional | | $55,272.32 | $56,377.77 | $77,820.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,792.99 / $64,821.73 / $68,233.39
| Facility | | $57,792.99 | $64,821.73 | $68,233.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57,848.13 / $57,848.13 / $57,848.13
| Professional | | $57,848.13 | $57,848.13 | $57,848.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,143.70 / $55,272.32 / $69,983.00
| Facility | | $52,143.70 | $55,272.32 | $69,983.00 |
- 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 / $77,820.00 / $85,373.55
| Facility | | $55,945.97 | $77,820.00 | $85,373.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,945.97 / $62,279.61 / $245,198.88
| Professional | | $55,945.97 | $62,279.61 | $245,198.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $58,588.66 / $65,774.06
| Professional | | $55,272.32 | $58,588.66 | $65,774.06 |