- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $10,471.29 / $22,908.68
| Facility | | $4,265.80 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,000.00 / $3,162.28
| Professional | | $724.44 | $1,000.00 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,125.38 / $26,915.35
| Facility | | $8,511.38 | $14,125.38 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,202.26 / $2,511.89
| Professional | | $851.14 | $1,202.26 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $100.00 / $6,025.60
| Facility | | $60.26 | $100.00 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $977.24 / $2,041.74
| Professional | | $691.83 | $977.24 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $954.99 / $2,041.74
| Professional | | $776.25 | $954.99 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $691.83 / $891.25
| Professional | | $645.65 | $691.83 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $776.25 / $1,778.28
| Professional | | $588.84 | $776.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $9,332.54
| Facility | | $54.95 | $56.23 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,370.32 / $6,456.54 / $6,456.54
| Professional | | $5,370.32 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $912.01 / $1,348.96
| Facility | | $676.08 | $912.01 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $954.99 / $2,041.74
| Professional | | $776.25 | $954.99 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $6,165.95 / $18,620.87
| Facility | | $2,041.74 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $977.24 / $2,041.74
| Professional | | $660.69 | $977.24 | $2,041.74 |