- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $5,370.32 / $8,511.38
| Facility | | $1,288.25 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $1,584.89 / $3,162.28
| Professional | | $177.83 | $1,584.89 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,162.28 / $5,128.61
| Professional | | $1,862.09 | $3,162.28 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $537.03 / $3,801.89
| Professional | | $204.17 | $537.03 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,365.16
| Professional | | $3,090.30 | $3,981.07 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $2,630.27 / $4,466.84
| Professional | | $380.19 | $2,630.27 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,570.88 / $8,511.38
| Facility | | $1,023.29 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $1,584.89 / $5,495.41
| Professional | | $181.97 | $1,584.89 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $5,370.32 / $5,370.32
| Facility | | $5,370.32 | $5,370.32 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,019.95 / $4,168.69 / $5,370.32
| Professional | | $3,019.95 | $4,168.69 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $588.84 / $2,238.72
| Facility | | $204.17 | $588.84 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $407.38 / $2,238.72
| Professional | | $204.17 | $407.38 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,981.07 / $12,022.64
| Facility | | $2,089.30 | $3,981.07 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $1,412.54 / $3,801.89
| Professional | | $177.83 | $1,412.54 | $3,801.89 |