- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,332.81 / $8,934.00 / $19,733.00
| Facility | | $1,332.81 | $8,934.00 | $19,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.52 / $1,087.77 / $5,398.72
| Professional | | $275.52 | $1,087.77 | $5,398.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $6,048.00 / $14,570.00
| Facility | | $2,143.00 | $6,048.00 | $14,570.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.43 / $909.19 / $2,792.03
| Professional | | $382.43 | $909.19 | $2,792.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $20,559.83
| Facility | | $66.00 | $100.00 | $20,559.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.52 / $1,037.48 / $2,626.82
| Professional | | $327.52 | $1,037.48 | $2,626.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,445.48 / $6,435.57 / $15,161.65
| Facility | | $5,445.48 | $6,435.57 | $15,161.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.10 / $1,066.29 / $2,717.84
| Professional | | $331.10 | $1,066.29 | $2,717.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.25 / $1,213.23 / $2,496.98
| Professional | | $366.25 | $1,213.23 | $2,496.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.63 / $860.83 / $1,654.41
| Professional | | $329.63 | $860.83 | $1,654.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,576.52 / $1,598.85 / $26,542.00
| Facility | | $1,576.52 | $1,598.85 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,620.00 / $10,075.35 / $10,407.83
| Professional | | $4,620.00 | $10,075.35 | $10,407.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.84 / $890.80 / $2,079.86
| Facility | | $381.84 | $890.80 | $2,079.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.54 / $1,073.20 / $2,557.73
| Professional | | $334.54 | $1,073.20 | $2,557.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,035.65 / $1,035.65 / $3,349.79
| Professional | | $1,035.65 | $1,035.65 | $3,349.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.85 / $1,226.34 / $2,970.06
| Professional | | $406.85 | $1,226.34 | $2,970.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $13,784.00 / $32,191.00
| Facility | | $7,212.00 | $13,784.00 | $32,191.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $822.34 / $1,293.85 / $3,538.06
| Professional | | $822.34 | $1,293.85 | $3,538.06 |