- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,754.40 / $8,511.38
| Facility | | $1,047.13 | $5,754.40 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,122.02 / $2,951.21
| Professional | | $912.01 | $1,122.02 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,380.38 / $1,778.28
| Professional | | $812.83 | $1,380.38 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,288.25 / $1,862.09
| Professional | | $933.25 | $1,288.25 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,513.56
| Professional | | $1,348.96 | $1,348.96 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,288.25 / $2,137.96
| Professional | | $1,047.13 | $1,288.25 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,265.80 / $8,317.64
| Facility | | $1,023.29 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,202.26 / $3,162.28
| Professional | | $933.25 | $1,202.26 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,445.44 / $2,187.76
| Professional | | $1,380.38 | $1,445.44 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,445.44 / $1,445.44
| Facility | | $912.01 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $933.25 / $1,905.46
| Professional | | $870.96 | $933.25 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,570.40 / $6,760.83
| Facility | | $660.69 | $2,570.40 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,230.27 / $1,949.84
| Professional | | $891.25 | $1,230.27 | $1,949.84 |