- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $5,495.41 / $6,918.31
| Facility | | $4,786.30 | $5,495.41 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $776.25 / $1,318.26
| Professional | | $537.03 | $776.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,981.07 / $8,317.64
| Facility | | $1,698.24 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,071.52 / $1,288.25
| Professional | | $912.01 | $1,071.52 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $891.25 / $1,122.02
| Professional | | $645.65 | $891.25 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $977.24 / $1,659.59
| Facility | | $562.34 | $977.24 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,096.48 / $1,318.26
| Professional | | $831.76 | $1,096.48 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,244.36 / $10,232.93
| Facility | | $5,248.07 | $7,244.36 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,122.02 / $1,380.38
| Professional | | $776.25 | $1,122.02 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $977.24 / $5,128.61
| Professional | | $575.44 | $977.24 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,495.41 / $12,302.69
| Facility | | $1,348.96 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $954.99 / $1,412.54
| Professional | | $630.96 | $954.99 | $1,412.54 |