- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.50 / $2,747.00 / $7,920.26
| Facility | | $1,461.50 | $2,747.00 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.09 / $1,015.10 / $2,333.27
| Professional | | $660.09 | $1,015.10 | $2,333.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $842.00 / $842.00
| Facility | | $842.00 | $842.00 | $842.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.58 / $1,417.64 / $2,170.91
| Professional | | $865.58 | $1,417.64 | $2,170.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,376.81 / $1,612.68 / $1,934.76
| Professional | | $1,376.81 | $1,612.68 | $1,934.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.45 / $1,339.82 / $1,776.50
| Facility | | $900.45 | $1,339.82 | $1,776.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,131.25 / $1,273.65 / $1,965.06
| Professional | | $1,131.25 | $1,273.65 | $1,965.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.92 / $1,368.66 / $1,493.43
| Facility | | $1,002.92 | $1,368.66 | $1,493.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.45 / $1,339.82 / $1,897.26
| Facility | | $900.45 | $1,339.82 | $1,897.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,252.90 / $1,486.56 / $2,042.96
| Professional | | $1,252.90 | $1,486.56 | $2,042.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,472.14 / $39,875.19 / $51,188.76
| Facility | | $18,472.14 | $39,875.19 | $51,188.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,359.83 / $1,739.73 / $2,338.21
| Professional | | $1,359.83 | $1,739.73 | $2,338.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $18,628.00 / $26,255.00
| Facility | | $3,028.00 | $18,628.00 | $26,255.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,036.35 / $1,501.66 / $2,280.83
| Professional | | $1,036.35 | $1,501.66 | $2,280.83 |