- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,128.61 / $17,782.79
| Facility | | $1,548.82 | $5,128.61 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,318.26 / $3,467.37
| Professional | | $1,122.02 | $1,318.26 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $1,819.70
| Professional | | $245.47 | $245.47 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,897.79 / $11,220.18
| Facility | | $2,238.72 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,479.11 / $2,344.23
| Professional | | $1,174.90 | $1,479.11 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,380.38 / $1,905.46
| Professional | | $1,174.90 | $1,380.38 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,791.08 / $20,417.38
| Facility | | $8,511.38 | $14,791.08 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,659.59 / $2,691.53
| Professional | | $1,148.15 | $1,659.59 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $2,137.96 / $26,302.68
| Facility | | $1,174.90 | $2,137.96 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,698.24 / $9,332.54
| Professional | | $1,174.90 | $1,698.24 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,265.80 / $11,481.54
| Facility | | $2,884.03 | $4,265.80 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,479.11 / $2,344.23
| Professional | | $1,122.02 | $1,479.11 | $2,344.23 |