- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,089.30 / $14,454.40
| Facility | | $1,000.00 | $2,089.30 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,047.13 / $2,754.23
| Professional | | $933.25 | $1,047.13 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $15,488.17 / $26,302.68
| Facility | | $11,481.54 | $15,488.17 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,041.74 / $5,248.07
| Professional | | $1,000.00 | $2,041.74 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,090.30 / $5,128.61
| Facility | | $2,630.27 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $4,168.69 / $4,677.35
| Professional | | $1,318.26 | $4,168.69 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,041.74 / $6,456.54
| Facility | | $1,023.29 | $2,041.74 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,454.71 / $3,162.28
| Professional | | $1,819.70 | $2,454.71 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,089.30 / $15,135.61
| Facility | | $1,023.29 | $2,089.30 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,862.09 / $7,585.78
| Professional | | $1,047.13 | $1,862.09 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,290.87 / $3,467.37
| Professional | | $1,479.11 | $2,290.87 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $13,489.63 / $19,952.62
| Facility | | $7,244.36 | $13,489.63 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,897.79 / $7,413.10
| Professional | | $1,819.70 | $4,897.79 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $3,311.31
| Professional | | $3,311.31 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,623.41 / $6,456.54
| Professional | | $2,818.38 | $5,623.41 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,548.82 / $4,168.69
| Professional | | $1,023.29 | $1,548.82 | $4,168.69 |