- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,197.01 / $29,512.09
| Facility | | $13,803.84 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $28,183.83 / $44,668.36
| Facility | | $23,988.33 | $28,183.83 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,290.87 / $31,622.78
| Professional | | $1,380.38 | $2,290.87 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $7,943.28 / $15,135.61
| Facility | | $933.25 | $7,943.28 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,344.23 / $25,118.86
| Professional | | $1,513.56 | $2,344.23 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $12,302.69 / $21,379.62
| Facility | | $741.31 | $12,302.69 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,471.29 / $19,952.62 / $44,668.36
| Professional | | $10,471.29 | $19,952.62 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $50.12 / $11,748.98
| Professional | | $32.36 | $50.12 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $64,565.42
| Facility | | $43,651.58 | $43,651.58 | $64,565.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48,977.88 / $60,255.96 / $60,255.96
| Professional | | $48,977.88 | $60,255.96 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $18,197.01 / $19,952.62
| Facility | | $17,378.01 | $18,197.01 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $7,762.47 / $39,810.72
| Professional | | $954.99 | $7,762.47 | $39,810.72 |