- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,786.30 / $8,317.64
| Facility | | $1,047.13 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $954.99 / $1,995.26
| Professional | | $831.76 | $954.99 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $954.99 / $1,698.24
| Professional | | $912.01 | $954.99 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $2,884.03
| Professional | | $954.99 | $2,344.23 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,380.38 / $1,778.28
| Professional | | $1,023.29 | $1,380.38 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,122.02 / $1,819.70
| Professional | | $851.14 | $1,122.02 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,801.89 / $8,317.64
| Facility | | $954.99 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,230.27 / $2,691.53
| Professional | | $851.14 | $1,230.27 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,862.09
| Facility | | $1,122.02 | $1,122.02 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,288.25 / $1,949.84
| Professional | | $1,047.13 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $891.25
| Facility | | $467.74 | $467.74 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $467.74 / $912.01
| Professional | | $316.23 | $467.74 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,466.84 / $22,387.21
| Facility | | $2,344.23 | $4,466.84 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,047.13 / $1,737.80
| Professional | | $776.25 | $1,047.13 | $1,737.80 |