- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $4,051.00 / $9,617.00
| Facility | | $1,054.00 | $4,051.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $915.78 / $1,026.51 / $1,509.70
| Professional | | $915.78 | $1,026.51 | $1,509.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,014.67 / $1,052.96 / $1,052.96
| Professional | | $1,014.67 | $1,052.96 | $1,052.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.48 / $1,146.48 / $1,146.48
| Facility | | $1,146.48 | $1,146.48 | $1,146.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $892.28 / $1,240.52 / $2,020.22
| Professional | | $892.28 | $1,240.52 | $2,020.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,178.79 / $1,563.08 / $2,036.10
| Professional | | $1,178.79 | $1,563.08 | $2,036.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,123.02 / $11,123.02 / $12,495.40
| Facility | | $11,123.02 | $11,123.02 | $12,495.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.00 / $5,350.00 / $10,247.00
| Facility | | $1,151.00 | $5,350.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $937.03 / $1,143.88 / $4,986.37
| Professional | | $937.03 | $1,143.88 | $4,986.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,107.59 / $1,107.59 / $2,059.10
| Professional | | $1,107.59 | $1,107.59 | $2,059.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.48 / $1,146.48 / $1,146.48
| Facility | | $1,146.48 | $1,146.48 | $1,146.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $936.21 / $1,266.33 / $2,031.77
| Professional | | $936.21 | $1,266.33 | $2,031.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $994.76 / $994.76 / $1,172.83
| Facility | | $994.76 | $994.76 | $1,172.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $968.93 / $995.17 / $1,172.83
| Professional | | $968.93 | $995.17 | $1,172.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $944.79 / $1,259.70 / $2,076.40
| Professional | | $944.79 | $1,259.70 | $2,076.40 |