- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $17,782.79
| Facility | | $501.19 | $501.19 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $794.33 / $2,511.89
| Professional | | $478.63 | $794.33 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,047.13 / $2,398.83
| Professional | | $691.83 | $1,047.13 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,951.21 / $4,677.35
| Facility | | $2,511.89 | $2,951.21 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,621.81 / $1,819.70
| Professional | | $1,071.52 | $1,621.81 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $891.25 / $3,548.13
| Facility | | $501.19 | $891.25 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Professional | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,000.00 / $11,220.18
| Facility | | $501.19 | $1,000.00 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,258.93 / $6,456.54
| Professional | | $338.84 | $1,258.93 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $58.88 / $70.79
| Professional | | $33.11 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,995.26 / $2,884.03
| Professional | | $1,148.15 | $1,995.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $7,943.28 / $12,022.64
| Facility | | $7,943.28 | $7,943.28 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $6,309.57 / $6,309.57
| Professional | | $1,862.09 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,548.13 / $5,011.87 / $5,495.41
| Professional | | $3,548.13 | $5,011.87 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,047.13 / $3,388.44
| Professional | | $338.84 | $1,047.13 | $3,388.44 |