- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $6,732.07 / $16,762.57
| Facility | | $4,083.97 | $6,732.07 | $16,762.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.62 / $670.34 / $2,191.00
| Professional | | $412.62 | $670.34 | $2,191.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.41 / $745.51 / $805.96
| Professional | | $623.41 | $745.51 | $805.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.31 / $3,250.33 / $6,101.70
| Facility | | $2,398.31 | $3,250.33 | $6,101.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.99 / $764.97 / $1,055.22
| Professional | | $437.99 | $764.97 | $1,055.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $999.40 / $1,281.61 / $1,602.02
| Professional | | $999.40 | $1,281.61 | $1,602.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.65 / $870.82 / $4,606.00
| Facility | | $515.65 | $870.82 | $4,606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.84 / $1,243.10 / $4,197.28
| Professional | | $644.84 | $1,243.10 | $4,197.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.49 / $1,266.36 / $2,691.59
| Facility | | $947.49 | $1,266.36 | $2,691.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $807.96 / $1,120.07 / $1,538.18
| Professional | | $807.96 | $1,120.07 | $1,538.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $605.79 / $1,491.00
| Professional | | $3.00 | $605.79 | $1,491.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $767.67 / $1,180.98 / $1,331.92
| Professional | | $767.67 | $1,180.98 | $1,331.92 |