- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55,272.32 / $55,946.00 / $55,946.00
| Facility | | $55,272.32 | $55,946.00 | $55,946.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $55,272.32 / $60,799.56
| Professional | | $55,272.32 | $55,272.32 | $60,799.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,711.85 / $59,964.94 / $61,081.29
| Facility | | $43,711.85 | $59,964.94 | $61,081.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64,396.68 / $67,785.97 / $68,612.13
| Professional | | $64,396.68 | $67,785.97 | $68,612.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,272.32 / $66,615.34 / $87,806.34
| Professional | | $55,272.32 | $66,615.34 | $87,806.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,426.66 / $81,399.72 / $109,094.64
| Facility | | $53,426.66 | $81,399.72 | $109,094.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,945.97 / $59,302.73 / $83,918.96
| Professional | | $55,945.97 | $59,302.73 | $83,918.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,141.44 / $68,420.52 / $108,332.50
| Facility | | $57,141.44 | $68,420.52 | $108,332.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47,427.38 / $68,420.52 / $87,806.34
| Professional | | $47,427.38 | $68,420.52 | $87,806.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63,652.81 / $78,685.39 / $112,755.54
| Professional | | $63,652.81 | $78,685.39 | $112,755.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52,508.70 / $55,272.32 / $65,774.06
| Professional | | $52,508.70 | $55,272.32 | $65,774.06 |