- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $17,378.01 / $29,512.09
| Facility | | $8,511.38 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,495.41 / $7,413.10
| Professional | | $3,801.89 | $5,495.41 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $5,248.07
| Professional | | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,232.93 / $22,908.68
| Facility | | $4,466.84 | $10,232.93 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $32,359.37
| Professional | | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,079.46 / $9,120.11 / $14,791.08
| Professional | | $7,079.46 | $9,120.11 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $16,982.44
| Professional | | $7,244.36 | $11,220.18 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $17,378.01 / $29,512.09
| Facility | | $7,943.28 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,495.41 / $23,988.33
| Professional | | $4,073.80 | $5,495.41 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Professional | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $6,918.31
| Professional | | $6,760.83 | $6,760.83 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $8,128.31
| Facility | | $6,760.83 | $6,760.83 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,818.38 / $4,073.80 / $8,511.38
| Professional | | $2,818.38 | $4,073.80 | $8,511.38 |