- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,761.35 / $3,777.49 / $8,074.63
| Facility | | $1,761.35 | $3,777.49 | $8,074.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,549.23 / $1,866.07 / $2,575.59
| Professional | | $1,549.23 | $1,866.07 | $2,575.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,769.10 / $8,883.46 / $15,216.00
| Facility | | $4,769.10 | $8,883.46 | $15,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,540.62 / $2,095.25 / $3,141.64
| Professional | | $1,540.62 | $2,095.25 | $3,141.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,803.35 / $1,803.35 / $4,738.54
| Facility | | $1,803.35 | $1,803.35 | $4,738.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,671.92 / $2,383.76 / $3,928.01
| Professional | | $1,671.92 | $2,383.76 | $3,928.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,292.00 / $3,325.00 / $8,152.00
| Facility | | $1,292.00 | $3,325.00 | $8,152.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,632.26 / $2,307.13 / $4,022.90
| Professional | | $1,632.26 | $2,307.13 | $4,022.90 |