- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,168.69 / $5,370.32
| Professional | | $3,311.31 | $4,168.69 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $66.07 / $19,054.61
| Professional | | $56.23 | $66.07 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $17,782.79 / $28,183.83
| Facility | | $15,135.61 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,309.57 / $13,803.84 / $16,982.44
| Professional | | $6,309.57 | $13,803.84 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $22,908.68 / $34,673.69
| Facility | | $5,623.41 | $22,908.68 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $36,307.81
| Professional | | $33,113.11 | $33,113.11 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $6,606.93 / $19,054.61
| Facility | | $4,897.79 | $6,606.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,311.31 / $27,542.29
| Professional | | $2,454.71 | $3,311.31 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $70.79 / $2,754.23
| Professional | | $50.12 | $70.79 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,882.50 / $18,197.01
| Professional | | $8,912.51 | $12,882.50 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $26,302.68 / $26,302.68
| Facility | | $10,964.78 | $26,302.68 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,943.28 / $21,877.62 / $27,542.29
| Professional | | $7,943.28 | $21,877.62 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $11,748.98
| Professional | | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28,840.32 / $30,199.52 / $30,199.52
| Professional | | $28,840.32 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $4,365.16 / $6,606.93
| Facility | | $4,365.16 | $4,365.16 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,311.31 / $9,120.11
| Professional | | $2,290.87 | $3,311.31 | $9,120.11 |