- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,402.01 / $4,794.45 / $8,451.79
| Facility | | $1,402.01 | $4,794.45 | $8,451.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,099.60 / $1,099.60 / $1,134.71
| Professional | | $1,099.60 | $1,099.60 | $1,134.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $5,861.55
| Facility | | $244.00 | $614.00 | $5,861.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.83 / $346.60 / $749.73
| Professional | | $288.83 | $346.60 | $749.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $1,544.14 / $10,493.11
| Facility | | $59.40 | $1,544.14 | $10,493.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $793.50 / $1,133.57 / $2,849.68
| Professional | | $793.50 | $1,133.57 | $2,849.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,094.93 / $2,289.81 / $5,707.52
| Facility | | $1,094.93 | $2,289.81 | $5,707.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,743.95 / $2,092.73 / $2,790.32
| Professional | | $1,743.95 | $2,092.73 | $2,790.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,569.56 / $2,005.54 / $3,330.94
| Professional | | $1,569.56 | $2,005.54 | $3,330.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,034.47 / $8,283.76 / $8,283.76
| Facility | | $3,034.47 | $8,283.76 | $8,283.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,684.87 / $8,684.87 / $13,079.63
| Professional | | $8,684.87 | $8,684.87 | $13,079.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,133.57 / $2,092.73 / $4,569.10
| Facility | | $1,133.57 | $2,092.73 | $4,569.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,743.95 / $1,918.35 / $2,615.92
| Professional | | $1,743.95 | $1,918.35 | $2,615.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,169.80 / $1,169.80 / $1,169.80
| Professional | | $1,169.80 | $1,169.80 | $1,169.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.32 / $532.26 / $2,451.32
| Professional | | $491.32 | $532.26 | $2,451.32 |