- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,546.09 / $10,550.00 / $22,788.00
| Facility | | $3,546.09 | $10,550.00 | $22,788.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $950.74 / $1,111.01 / $3,907.99
| Professional | | $950.74 | $1,111.01 | $3,907.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,540.00 / $15,357.00 / $37,532.26
| Facility | | $5,540.00 | $15,357.00 | $37,532.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,323.01 / $1,686.27 / $3,269.25
| Professional | | $1,323.01 | $1,686.27 | $3,269.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.50 / $100.00 / $5,485.17
| Facility | | $63.50 | $100.00 | $5,485.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $700.16 / $1,044.85 / $2,200.59
| Professional | | $700.16 | $1,044.85 | $2,200.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,060.03 / $1,310.06 / $2,812.55
| Professional | | $1,060.03 | $1,310.06 | $2,812.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $890.54 / $1,086.21 / $1,335.81
| Professional | | $890.54 | $1,086.21 | $1,335.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.59 / $1,237.80 / $2,293.21
| Professional | | $977.59 | $1,237.80 | $2,293.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $10,710.48 / $13,279.20
| Facility | | $55.00 | $10,710.48 | $13,279.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,394.00 / $7,593.44 / $8,951.10
| Professional | | $7,394.00 | $7,593.44 | $8,951.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,012.19 / $1,277.29 / $1,743.82
| Facility | | $1,012.19 | $1,277.29 | $1,743.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,042.36 / $1,310.06 / $2,957.86
| Professional | | $1,042.36 | $1,310.06 | $2,957.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $890.54 / $1,157.70 / $1,513.92
| Professional | | $890.54 | $1,157.70 | $1,513.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,047.00 / $5,319.00 / $20,279.00
| Facility | | $2,047.00 | $5,319.00 | $20,279.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.33 / $1,324.27 / $2,923.44
| Professional | | $910.33 | $1,324.27 | $2,923.44 |