- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,344.15 / $4,443.50 / $8,572.13
| Facility | | $1,344.15 | $4,443.50 | $8,572.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,044.07 / $1,318.17 / $1,400.00
| Professional | | $1,044.07 | $1,318.17 | $1,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.90 / $100.00 / $2,261.53
| Facility | | $66.90 | $100.00 | $2,261.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,307.00 / $8,673.83 / $17,407.47
| Facility | | $4,307.00 | $8,673.83 | $17,407.47 |
- 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
- $7,567.50 / $9,667.50 / $16,848.00
| Facility | | $7,567.50 | $9,667.50 | $16,848.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $773.43 / $1,619.24 / $1,834.63
| Professional | | $773.43 | $1,619.24 | $1,834.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,320.35 / $1,615.48 / $2,814.18
| Professional | | $1,320.35 | $1,615.48 | $2,814.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $89.13
| Professional | | $40.00 | $40.00 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,493.35 / $1,493.35 / $2,000.00
| Facility | | $1,493.35 | $1,493.35 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $705.23 / $872.81 / $2,097.42
| Professional | | $705.23 | $872.81 | $2,097.42 |
- 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
- $1,154.33 / $1,827.71 / $2,830.30
| Professional | | $1,154.33 | $1,827.71 | $2,830.30 |