- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.17 / $2,720.90 / $20,680.40
| Facility | | $1,326.17 | $2,720.90 | $20,680.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $955.84 / $1,326.17 / $2,720.90
| Professional | | $955.84 | $1,326.17 | $2,720.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,404.75 / $19,436.32
| Facility | | $55.00 | $1,404.75 | $19,436.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.49 / $2,456.07 / $9,631.00
| Professional | | $1,445.49 | $2,456.07 | $9,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,386.48 / $2,090.96 / $3,139.63
| Professional | | $1,386.48 | $2,090.96 | $3,139.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $989.52 / $2,192.40 / $2,662.63
| Facility | | $989.52 | $2,192.40 | $2,662.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,283.38 / $2,230.60 / $2,835.56
| Professional | | $1,283.38 | $2,230.60 | $2,835.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.85 / $306.41 / $2,290.95
| Professional | | $78.85 | $306.41 | $2,290.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,514.10 / $2,010.98 / $2,119.21
| Facility | | $1,514.10 | $2,010.98 | $2,119.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,404.75 / $1,404.75 / $1,445.49
| Facility | | $1,404.75 | $1,404.75 | $1,445.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,487.88 / $2,396.07 / $2,869.16
| Professional | | $1,487.88 | $2,396.07 | $2,869.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,432.66 / $2,079.36 / $2,800.84
| Professional | | $1,432.66 | $2,079.36 | $2,800.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,323.00 / $36,803.00
| Facility | | $1,120.00 | $3,323.00 | $36,803.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,339.80 / $2,008.49 / $3,014.55
| Professional | | $1,339.80 | $2,008.49 | $3,014.55 |