- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,388.44 / $5,623.41
| Facility | | $2,089.30 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,398.83 / $5,888.44
| Professional | | $2,041.74 | $2,398.83 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,454.71 / $19,952.62
| Facility | | $56.23 | $2,454.71 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,162.28 / $18,620.87
| Professional | | $2,041.74 | $3,162.28 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $741.31
| Facility | | $50.12 | $676.08 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $2,951.21 / $6,165.95
| Professional | | $575.44 | $2,951.21 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $3,311.31 / $8,511.38
| Facility | | $302.00 | $3,311.31 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,019.95 / $4,466.84
| Professional | | $2,187.76 | $3,019.95 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,801.89 / $5,754.40
| Professional | | $2,137.96 | $3,801.89 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,454.71 / $19,952.62
| Facility | | $56.23 | $2,454.71 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,162.28 / $18,620.87
| Professional | | $2,041.74 | $3,162.28 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,162.28 / $6,309.57
| Professional | | $2,137.96 | $3,162.28 | $6,309.57 |