- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,155.24 / $3,964.00 / $8,509.00
| Facility | | $1,155.24 | $3,964.00 | $8,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,001.55 / $1,126.58 / $1,630.74
| Professional | | $1,001.55 | $1,126.58 | $1,630.74 |
- 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
- $1,115.22 / $1,202.85 / $2,040.61
| Professional | | $1,115.22 | $1,202.85 | $2,040.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,260.32 / $1,260.32 / $1,260.32
| Facility | | $1,260.32 | $1,260.32 | $1,260.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,052.08 / $1,349.57 / $2,244.82
| Professional | | $1,052.08 | $1,349.57 | $2,244.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,315.51 / $1,784.56 / $2,272.25
| Professional | | $1,315.51 | $1,784.56 | $2,272.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,424.89 / $14,424.89 / $15,291.45
| Facility | | $14,424.89 | $14,424.89 | $15,291.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,268.00 / $8,268.00 / $8,268.00
| Professional | | $8,268.00 | $8,268.00 | $8,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,155.24 / $4,761.00 / $9,211.00
| Facility | | $1,155.24 | $4,761.00 | $9,211.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,001.55 / $1,250.20 / $5,482.44
| Professional | | $1,001.55 | $1,250.20 | $5,482.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,363.90 / $1,363.90 / $2,264.69
| Professional | | $1,363.90 | $1,363.90 | $2,264.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,260.32 / $1,260.32 / $1,260.32
| Facility | | $1,260.32 | $1,260.32 | $1,260.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,052.08 / $1,380.00 / $2,311.44
| Professional | | $1,052.08 | $1,380.00 | $2,311.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.23 / $1,087.23 / $1,214.96
| Facility | | $1,087.23 | $1,087.23 | $1,214.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,051.82 / $1,094.64 / $1,214.96
| Professional | | $1,051.82 | $1,094.64 | $1,214.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,018.11 / $1,349.93 / $2,108.25
| Professional | | $1,018.11 | $1,349.93 | $2,108.25 |