- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,884.03 / $14,454.40
| Facility | | $1,548.82 | $2,884.03 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,584.89 / $2,884.03
| Professional | | $1,318.26 | $1,584.89 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,128.31 / $13,489.63
| Facility | | $5,011.87 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,630.27 / $6,918.31
| Professional | | $1,380.38 | $2,630.27 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,265.80 / $6,760.83
| Facility | | $3,630.78 | $4,265.80 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,162.28 / $5,888.44
| Professional | | $1,479.11 | $3,162.28 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,862.09 / $8,128.31
| Facility | | $1,348.96 | $1,862.09 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,019.95 / $4,786.30
| Professional | | $2,454.71 | $3,019.95 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,905.46 / $5,754.40
| Facility | | $1,412.54 | $1,905.46 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,398.83 / $10,471.29
| Professional | | $1,412.54 | $2,398.83 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,235.94 / $5,128.61
| Professional | | $1,819.70 | $3,235.94 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $11,481.54 / $11,481.54
| Facility | | $3,630.78 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.44 / $6,918.31 / $10,471.29
| Professional | | $1,445.44 | $6,918.31 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,128.61 / $5,128.61 / $5,128.61
| Professional | | $5,128.61 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,370.32 / $7,079.46
| Professional | | $4,466.84 | $5,370.32 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,995.26 / $5,370.32
| Professional | | $1,380.38 | $1,995.26 | $5,370.32 |