- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $7,244.36 / $11,220.18
| Facility | | $1,445.44 | $7,244.36 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $776.25 / $1,778.28
| Professional | | $676.08 | $776.25 | $1,778.28 |
- 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
- $1,047.13 / $1,230.27 / $1,445.44
| Professional | | $1,047.13 | $1,230.27 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,258.93
| Facility | | $1,258.93 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $870.96 / $1,479.11
| Professional | | $645.65 | $870.96 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,122.02 / $1,445.44
| Professional | | $831.76 | $1,122.02 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $933.25 / $1,949.84
| Professional | | $707.95 | $933.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $5,495.41 / $10,964.78
| Facility | | $1,122.02 | $5,495.41 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $977.24 / $2,187.76
| Professional | | $691.83 | $977.24 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $1,548.82
| Facility | | $794.33 | $794.33 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,000.00 / $1,479.11
| Professional | | $724.44 | $1,000.00 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $741.31 / $1,096.48
| Facility | | $724.44 | $741.31 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $776.25 / $1,096.48
| Professional | | $707.95 | $776.25 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $18,197.01
| Facility | | $1,348.96 | $3,548.13 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $851.14 / $1,445.44
| Professional | | $616.60 | $851.14 | $1,445.44 |