- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,778.28 / $14,454.40
| Facility | | $851.14 | $1,778.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $891.25 / $2,344.23
| Professional | | $794.33 | $891.25 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,128.31 / $13,182.57
| Facility | | $5,011.87 | $8,128.31 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,737.80 / $4,265.80
| Professional | | $851.14 | $1,737.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,630.27 / $4,168.69
| Facility | | $2,238.72 | $2,630.27 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,548.13 / $3,981.07
| Professional | | $1,288.25 | $3,548.13 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,737.80 / $10,000.00
| Facility | | $870.96 | $1,737.80 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,041.74 / $2,691.53
| Professional | | $1,548.82 | $2,041.74 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,778.28 / $13,182.57
| Facility | | $870.96 | $1,778.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,659.59 / $6,760.83
| Professional | | $933.25 | $1,659.59 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,905.46 / $2,884.03
| Professional | | $1,258.93 | $1,905.46 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,495.41 / $5,495.41
| Facility | | $2,238.72 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $7,079.46
| Professional | | $1,513.56 | $4,168.69 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Professional | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,786.30 / $5,495.41
| Professional | | $2,187.76 | $4,786.30 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,595.87
| Facility | | $7,585.78 | $12,302.69 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,348.96 / $3,548.13
| Professional | | $912.01 | $1,348.96 | $3,548.13 |