- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,795.35 / $3,724.07 / $8,373.50
| Facility | | $1,795.35 | $3,724.07 | $8,373.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,585.40 / $2,179.63 / $2,925.47
| Professional | | $1,585.40 | $2,179.63 | $2,925.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,344.00 / $9,667.50 / $17,303.00
| Facility | | $6,344.00 | $9,667.50 | $17,303.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,921.98 / $2,050.11 / $2,216.67
| Facility | | $1,921.98 | $2,050.11 | $2,216.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.90 / $100.00 / $5,509.60
| Facility | | $66.90 | $100.00 | $5,509.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,563.78 / $10,216.95 / $13,180.78
| Facility | | $8,563.78 | $10,216.95 | $13,180.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,307.00 / $9,032.74 / $18,989.00
| Facility | | $4,307.00 | $9,032.74 | $18,989.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.00 / $270.00 / $555.04
| Professional | | $189.00 | $270.00 | $555.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.35 / $1,676.62 / $2,466.99
| Professional | | $672.35 | $1,676.62 | $2,466.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $612.41 / $720.48 / $720.48
| Professional | | $612.41 | $720.48 | $720.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,319.23 / $2,823.41 / $2,823.41
| Professional | | $2,319.23 | $2,823.41 | $2,823.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $948.51 / $1,607.88 / $2,205.83
| Professional | | $948.51 | $1,607.88 | $2,205.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,210.85 / $2,896.01 / $5,142.51
| Facility | | $2,210.85 | $2,896.01 | $5,142.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,250.15 / $2,361.55 / $3,090.13
| Professional | | $2,250.15 | $2,361.55 | $3,090.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $5,111.00 / $9,202.00
| Facility | | $2,200.00 | $5,111.00 | $9,202.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.02 / $1,574.57 / $3,383.01
| Professional | | $565.02 | $1,574.57 | $3,383.01 |