- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,007.66 / $1,007.66 / $5,801.95
| Professional | | $1,007.66 | $1,007.66 | $5,801.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.65 / $9,144.62 / $17,688.66
| Facility | | $6,952.65 | $9,144.62 | $17,688.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $973.42 / $1,659.26 / $2,212.34
| Professional | | $973.42 | $1,659.26 | $2,212.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,711.00 / $2,450.44 / $3,285.13
| Professional | | $1,711.00 | $2,450.44 | $3,285.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,007.66 / $1,763.41 / $7,279.02
| Facility | | $1,007.66 | $1,763.41 | $7,279.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,343.16 / $2,221.38 / $3,039.37
| Professional | | $1,343.16 | $2,221.38 | $3,039.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.58 / $2,511.69 / $3,441.36
| Facility | | $1,284.58 | $2,511.69 | $3,441.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,860.03 / $2,286.17 / $3,285.13
| Professional | | $1,860.03 | $2,286.17 | $3,285.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,343.16 / $2,264.96 / $2,892.96
| Professional | | $1,343.16 | $2,264.96 | $2,892.96 |