- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,311.31 / $8,912.51
| Facility | | $2,511.89 | $3,311.31 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,089.30 / $7,079.46
| Professional | | $1,778.28 | $2,089.30 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $15,488.17 / $24,547.09
| Facility | | $5,248.07 | $15,488.17 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,089.30 / $3,162.28
| Professional | | $1,905.46 | $2,089.30 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,290.87 / $3,235.94
| Professional | | $1,202.26 | $2,290.87 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $2,454.71
| Professional | | $32.36 | $33.11 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,290.87 / $3,715.35
| Facility | | $1,584.89 | $2,290.87 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,238.72 / $3,235.94
| Professional | | $1,202.26 | $2,238.72 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $11,220.18 / $25,703.96
| Facility | | $891.25 | $11,220.18 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,344.23 / $3,548.13
| Professional | | $1,698.24 | $2,344.23 | $3,548.13 |