- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,611.47 / $24,068.03
| Facility | | $4,241.22 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,019.81 / $1,019.81 / $5,811.31
| Professional | | $1,019.81 | $1,019.81 | $5,811.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,349.44 / $9,666.52 / $18,698.16
| Facility | | $7,349.44 | $9,666.52 | $18,698.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $987.04 / $1,682.48 / $2,243.30
| Professional | | $987.04 | $1,682.48 | $2,243.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,777.00 / $2,464.89 / $3,304.51
| Professional | | $1,777.00 | $2,464.89 | $3,304.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.81 / $1,784.67 / $8,816.00
| Facility | | $1,019.81 | $1,784.67 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,344.92 / $2,224.28 / $3,046.06
| Professional | | $1,344.92 | $2,224.28 | $3,046.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,932.00 / $2,556.19 / $6,616.19
| Facility | | $1,932.00 | $2,556.19 | $6,616.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,871.01 / $2,276.17 / $3,304.51
| Professional | | $1,871.01 | $2,276.17 | $3,304.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,344.92 / $2,289.46 / $2,896.74
| Professional | | $1,344.92 | $2,289.46 | $2,896.74 |