- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,079.46 / $18,197.01
| Facility | | $2,691.53 | $7,079.46 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,754.23 / $3,019.95
| Professional | | $2,344.23 | $2,754.23 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $6,309.57 / $9,549.93
| Facility | | $1,949.84 | $6,309.57 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,754.23 / $2,951.21 / $5,888.44
| Professional | | $2,754.23 | $2,951.21 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,467.37 / $11,481.54
| Facility | | $2,089.30 | $3,467.37 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $4,265.80 / $5,370.32
| Professional | | $16.98 | $4,265.80 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,951.21 / $16,595.87
| Facility | | $2,344.23 | $2,951.21 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $3,548.13
| Professional | | $1,479.11 | $1,479.11 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,548.13 / $4,265.80
| Facility | | $2,630.27 | $3,548.13 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $2,818.38
| Professional | | $1,479.11 | $1,479.11 | $2,818.38 |