- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,499.00 / $4,264.00 / $10,247.00
| Facility | | $1,499.00 | $4,264.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,440.99 / $1,643.18 / $2,414.46
| Professional | | $1,440.99 | $1,643.18 | $2,414.46 |
- 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
- $1,609.44 / $1,670.17 / $3,129.78
| Professional | | $1,609.44 | $1,670.17 | $3,129.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,877.47 / $1,877.47 / $1,877.47
| Facility | | $1,877.47 | $1,877.47 | $1,877.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,518.34 / $2,015.80 / $3,271.87
| Professional | | $1,518.34 | $2,015.80 | $3,271.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,879.17 / $2,493.78 / $3,245.85
| Professional | | $1,879.17 | $2,493.78 | $3,245.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,498.66 / $36,498.66 / $36,498.66
| Facility | | $36,498.66 | $36,498.66 | $36,498.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,350.00 / $10,510.00
| Facility | | $1,301.00 | $5,350.00 | $10,510.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,461.00 / $1,737.63 / $5,958.00
| Professional | | $1,461.00 | $1,737.63 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,655.70 / $1,655.70 / $3,438.20
| Professional | | $1,655.70 | $1,655.70 | $3,438.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,877.47 / $1,877.47 / $1,877.47
| Facility | | $1,877.47 | $1,877.47 | $1,877.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,527.97 / $2,041.67 / $3,377.10
| Professional | | $1,527.97 | $2,041.67 | $3,377.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.60 / $1,634.60 / $1,690.17
| Facility | | $1,634.60 | $1,634.60 | $1,690.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,595.85 / $1,634.60 / $1,726.74
| Professional | | $1,595.85 | $1,634.60 | $1,726.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,843.00 / $3,742.00 / $7,000.00
| Facility | | $1,843.00 | $3,742.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,468.53 / $1,953.85 / $3,088.25
| Professional | | $1,468.53 | $1,953.85 | $3,088.25 |