- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,905.46 / $13,182.57
| Facility | | $1,445.44 | $1,905.46 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $831.76 / $1,862.09
| Professional | | $616.60 | $831.76 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,318.26 / $1,995.26
| Professional | | $776.25 | $1,318.26 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,479.11 / $1,778.28
| Professional | | $1,122.02 | $1,479.11 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,148.15 / $1,778.28
| Facility | | $724.44 | $1,148.15 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,288.25 / $1,905.46
| Professional | | $1,023.29 | $1,288.25 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,380.38 / $1,479.11
| Facility | | $1,096.48 | $1,380.38 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,148.15 / $1,621.81
| Facility | | $741.31 | $1,148.15 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $1,348.96 / $1,949.84
| Professional | | $79.43 | $1,348.96 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $12,302.69
| Facility | | $7,762.47 | $10,232.93 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,513.56 / $2,137.96
| Professional | | $1,230.27 | $1,513.56 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $16,218.10 / $23,988.33
| Facility | | $2,884.03 | $16,218.10 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,380.38 / $1,995.26
| Professional | | $912.01 | $1,380.38 | $1,995.26 |