- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,709.25 / $5,954.66 / $16,368.90
| Facility | | $1,709.25 | $5,954.66 | $16,368.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,242.06 / $1,891.57 / $1,937.15
| Professional | | $1,242.06 | $1,891.57 | $1,937.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $11,417.79
| Facility | | $244.00 | $614.00 | $11,417.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $800.00 / $960.00 / $2,147.91
| Professional | | $800.00 | $960.00 | $2,147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $3,008.28 / $20,442.63
| Facility | | $59.40 | $3,008.28 | $20,442.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,036.95 / $1,481.35 / $3,704.12
| Professional | | $1,036.95 | $1,481.35 | $3,704.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,503.57 / $3,821.88 / $7,628.95
| Facility | | $1,503.57 | $3,821.88 | $7,628.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,823.20 / $2,279.00 / $3,076.65
| Professional | | $1,823.20 | $2,279.00 | $3,076.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,051.10 / $2,620.85 / $4,352.89
| Professional | | $2,051.10 | $2,620.85 | $4,352.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,965.46 / $10,825.25 / $10,825.25
| Facility | | $3,965.46 | $10,825.25 | $10,825.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,349.42 / $11,349.42 / $17,092.50
| Professional | | $11,349.42 | $11,349.42 | $17,092.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,823.20 / $2,734.80 / $6,046.87
| Facility | | $1,823.20 | $2,734.80 | $6,046.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,279.00 / $2,506.90 / $3,418.50
| Professional | | $2,279.00 | $2,506.90 | $3,418.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,823.20 / $2,051.10 / $3,099.44
| Professional | | $1,823.20 | $2,051.10 | $3,099.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $957.18 / $1,025.55 / $6,350.66
| Professional | | $957.18 | $1,025.55 | $6,350.66 |