- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $4,570.88 / $13,489.63
| Facility | | $1,778.28 | $4,570.88 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,380.38 / $3,388.44
| Professional | | $1,148.15 | $1,380.38 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $11,481.54 / $33,113.11
| Facility | | $2,238.72 | $11,481.54 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,445.44 / $2,454.71
| Professional | | $1,202.26 | $1,445.44 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,513.56 / $2,089.30
| Professional | | $1,258.93 | $1,513.56 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $14,454.40 / $17,782.79
| Facility | | $4,365.16 | $14,454.40 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,621.81 / $2,630.27
| Professional | | $1,096.48 | $1,621.81 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,949.84 / $14,791.08
| Facility | | $1,174.90 | $1,949.84 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,862.09 / $9,772.37
| Professional | | $1,202.26 | $1,862.09 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,235.94 / $14,791.08
| Facility | | $2,137.96 | $3,235.94 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,584.89 / $2,570.40
| Professional | | $1,148.15 | $1,584.89 | $2,570.40 |