- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,238.72 / $14,454.40
| Facility | | $1,071.52 | $2,238.72 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,096.48 / $3,311.31
| Professional | | $1,000.00 | $1,096.48 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,238.72 / $5,370.32
| Professional | | $1,071.52 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,311.31 / $5,248.07
| Facility | | $2,818.38 | $3,311.31 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,466.84 / $5,011.87
| Professional | | $1,513.56 | $4,466.84 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,238.72 / $10,232.93
| Facility | | $1,096.48 | $2,238.72 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,630.27 / $3,388.44
| Professional | | $1,949.84 | $2,630.27 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,398.83 / $13,489.63
| Facility | | $1,096.48 | $2,398.83 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,089.30 / $10,232.93
| Professional | | $1,148.15 | $2,089.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,290.87 / $3,467.37
| Professional | | $1,513.56 | $2,290.87 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $10,000.00 / $10,000.00
| Facility | | $2,818.38 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,248.07 / $10,232.93
| Professional | | $1,949.84 | $5,248.07 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,311.31 / $6,025.60 / $6,918.31
| Professional | | $3,311.31 | $6,025.60 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,218.10
| Facility | | $7,585.78 | $12,302.69 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,698.24 / $4,466.84
| Professional | | $1,148.15 | $1,698.24 | $4,466.84 |