- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,370.32 / $8,511.38
| Facility | | $1,047.13 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,023.29 / $2,041.74
| Professional | | $891.25 | $1,023.29 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,047.13 / $1,737.80
| Professional | | $1,000.00 | $1,047.13 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,174.90 / $1,995.26
| Professional | | $870.96 | $1,174.90 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,479.11 / $1,905.46
| Professional | | $1,096.48 | $1,479.11 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,174.90 / $1,862.09
| Professional | | $891.25 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,265.80 / $8,317.64
| Facility | | $1,023.29 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,318.26 / $2,754.23
| Professional | | $912.01 | $1,318.26 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $2,041.74
| Facility | | $1,288.25 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,380.38 / $1,949.84
| Professional | | $1,047.13 | $1,380.38 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,148.15 / $1,148.15
| Facility | | $977.24 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $977.24 / $1,148.15
| Professional | | $954.99 | $977.24 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,365.16 / $10,471.29
| Facility | | $2,344.23 | $4,365.16 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,122.02 / $1,905.46
| Professional | | $831.76 | $1,122.02 | $1,905.46 |