- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.00 / $3,682.00 / $12,826.00
| Facility | | $1,002.00 | $3,682.00 | $12,826.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,519.09 / $1,697.96 / $2,625.39
| Professional | | $1,519.09 | $1,697.96 | $2,625.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,809.62 / $3,070.87 / $15,273.93
| Facility | | $1,809.62 | $3,070.87 | $15,273.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,316.53 / $1,664.17 / $2,309.67
| Professional | | $1,316.53 | $1,664.17 | $2,309.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $1,627.48 / $1,668.51
| Facility | | $80.00 | $1,627.48 | $1,668.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,894.69 / $1,894.69 / $1,894.69
| Facility | | $1,894.69 | $1,894.69 | $1,894.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,695.81 / $2,332.03 / $3,639.24
| Professional | | $1,695.81 | $2,332.03 | $3,639.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $24,533.21
| Facility | | $55.00 | $55.00 | $24,533.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,832.64 / $12,150.24 / $14,365.35
| Professional | | $11,832.64 | $12,150.24 | $14,365.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.90 / $1,830.14 / $3,017.40
| Facility | | $1,481.90 | $1,830.14 | $3,017.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,037.03 / $2,444.42 / $3,031.09
| Professional | | $2,037.03 | $2,444.42 | $3,031.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.74 / $1,860.66 / $3,319.07
| Facility | | $1,487.74 | $1,860.66 | $3,319.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,724.23 / $2,392.91 / $3,650.28
| Professional | | $1,724.23 | $2,392.91 | $3,650.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $7,123.00 / $16,000.00
| Facility | | $2,600.00 | $7,123.00 | $16,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,381.11 / $1,906.79 / $3,046.98
| Professional | | $1,381.11 | $1,906.79 | $3,046.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,390.83 / $1,582.58 / $2,184.87
| Professional | | $1,390.83 | $1,582.58 | $2,184.87 |