- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $10,232.93 / $23,988.33
| Facility | | $4,897.79 | $10,232.93 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,489.63 / $22,387.21
| Facility | | $7,943.28 | $13,489.63 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $7,244.36 / $19,054.61
| Facility | | $66.07 | $7,244.36 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $8,912.51
| Facility | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,000.00 / $1,348.96
| Professional | | $794.33 | $1,000.00 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,096.48 / $2,187.76
| Professional | | $831.76 | $1,096.48 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $33,884.42 / $33,884.42
| Facility | | $25,703.96 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,258.93 / $1,995.26
| Facility | | $954.99 | $1,258.93 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $14,125.38 / $28,840.32
| Facility | | $7,762.47 | $14,125.38 | $28,840.32 |