- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $10,964.78 / $23,988.33
| Facility | | $5,248.07 | $10,964.78 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $588.84 / $6,309.57
| Professional | | $416.87 | $588.84 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $1,230.27 / $2,187.76
| Professional | | $229.09 | $1,230.27 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $812.83 / $8,128.31
| Facility | | $61.66 | $812.83 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,803.84 / $23,988.33
| Facility | | $9,549.93 | $13,803.84 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Professional | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,782.79 / $17,782.79 / $18,620.87
| Professional | | $17,782.79 | $17,782.79 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $398.11
| Professional | | $141.25 | $141.25 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,183.10 / $69,183.10 / $69,183.10
| Facility | | $69,183.10 | $69,183.10 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,011.87 / $5,011.87
| Professional | | $4,168.69 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $851.14 / $19,054.61
| Facility | | $588.84 | $851.14 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $616.60 / $630.96
| Professional | | $562.34 | $616.60 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $17,782.79 / $38,904.51
| Facility | | $9,332.54 | $17,782.79 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $758.58 / $1,659.59
| Professional | | $489.78 | $758.58 | $1,659.59 |