- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,347.31 / $4,051.00 / $9,534.00
| Facility | | $1,347.31 | $4,051.00 | $9,534.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,169.07 / $1,313.96 / $1,943.49
| Professional | | $1,169.07 | $1,313.96 | $1,943.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,300.84 / $1,404.42 / $2,392.38
| Professional | | $1,300.84 | $1,404.42 | $2,392.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,471.08 / $1,471.08 / $1,471.08
| Facility | | $1,471.08 | $1,471.08 | $1,471.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,223.89 / $1,581.27 / $2,618.04
| Professional | | $1,223.89 | $1,581.27 | $2,618.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,532.93 / $2,080.03 / $2,647.78
| Professional | | $1,532.93 | $2,080.03 | $2,647.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $0.50 / $5,340.70
| Facility | | $0.50 | $0.50 | $5,340.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,631.50 / $14,631.50 / $14,631.50
| Professional | | $14,631.50 | $14,631.50 | $14,631.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,342.00 / $10,247.00
| Facility | | $1,301.00 | $5,342.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,461.00 / $5,958.00
| Professional | | $1,174.90 | $1,461.00 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,577.20 / $1,577.20 / $2,637.90
| Professional | | $1,577.20 | $1,577.20 | $2,637.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,471.08 / $1,471.08 / $1,471.08
| Facility | | $1,471.08 | $1,471.08 | $1,471.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,223.89 / $1,608.41 / $2,683.46
| Professional | | $1,223.89 | $1,608.41 | $2,683.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,269.10 / $1,269.10 / $1,584.66
| Facility | | $1,269.10 | $1,269.10 | $1,584.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,227.07 / $1,278.49 / $1,584.66
| Professional | | $1,227.07 | $1,278.49 | $1,584.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,904.00
| Facility | | $2,468.00 | $4,563.00 | $9,904.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,187.00 / $1,580.48 / $2,559.81
| Professional | | $1,187.00 | $1,580.48 | $2,559.81 |