- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,569.27 / $2,551.16 / $14,482.00
| Facility | | $1,569.27 | $2,551.16 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $854.56 / $1,569.27 / $4,526.17
| Professional | | $854.56 | $1,569.27 | $4,526.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,712.00 / $12,656.00 / $19,835.00
| Facility | | $8,712.00 | $12,656.00 | $19,835.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,234.00 / $3,046.13 / $7,576.29
| Professional | | $1,234.00 | $3,046.13 | $7,576.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,192.67 / $3,730.89 / $6,017.79
| Facility | | $3,192.67 | $3,730.89 | $6,017.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,154.31 / $3,841.07 / $5,127.66
| Professional | | $2,154.31 | $3,841.07 | $5,127.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.24 / $1,958.60 / $2,725.57
| Facility | | $1,247.24 | $1,958.60 | $2,725.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,431.28 / $2,803.00 / $7,700.00
| Facility | | $1,431.28 | $2,803.00 | $7,700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,478.69 / $3,723.63 / $7,245.96
| Professional | | $1,478.69 | $3,723.63 | $7,245.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.00 / $1,133.84 / $2,868.39
| Professional | | $85.00 | $1,133.84 | $2,868.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.24 / $1,958.60 / $2,725.57
| Facility | | $1,247.24 | $1,958.60 | $2,725.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,549.94 / $3,937.52 / $5,164.14
| Professional | | $2,549.94 | $3,937.52 | $5,164.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,012.64 / $24,012.64 / $24,012.64
| Facility | | $24,012.64 | $24,012.64 | $24,012.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,204.92 / $6,144.60 / $11,932.00
| Professional | | $2,204.92 | $6,144.60 | $11,932.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,447.73 / $6,447.73 / $6,447.73
| Professional | | $6,447.73 | $6,447.73 | $6,447.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,792.84 / $8,607.20 / $8,607.20
| Professional | | $5,792.84 | $8,607.20 | $8,607.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,203.00 / $4,316.80 / $19,003.00
| Facility | | $2,203.00 | $4,316.80 | $19,003.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,478.69 / $3,747.53 / $6,037.59
| Professional | | $1,478.69 | $3,747.53 | $6,037.59 |