- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,197.85 / $7,858.00 / $18,681.00
| Facility | | $2,197.85 | $7,858.00 | $18,681.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.05 / $635.94 / $3,139.29
| Professional | | $565.05 | $635.94 | $3,139.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,776.00 / $8,484.00 / $16,676.00
| Facility | | $2,776.00 | $8,484.00 | $16,676.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.63 / $931.07 / $1,707.59
| Professional | | $672.63 | $931.07 | $1,707.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $9,778.71
| Facility | | $66.00 | $100.00 | $9,778.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.97 / $639.65 / $1,565.86
| Professional | | $413.97 | $639.65 | $1,565.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,091.14 / $2,471.35 / $5,822.29
| Facility | | $2,091.14 | $2,471.35 | $5,822.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.36 / $777.09 / $2,334.31
| Professional | | $583.36 | $777.09 | $2,334.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.67 / $745.09 / $1,126.80
| Professional | | $595.67 | $745.09 | $1,126.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.88 / $778.95 / $1,373.66
| Professional | | $601.88 | $778.95 | $1,373.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,858.61 / $9,388.90 / $26,542.00
| Facility | | $3,858.61 | $9,388.90 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,677.00 / $9,677.00 / $9,677.00
| Professional | | $9,677.00 | $9,677.00 | $9,677.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.94 / $818.67 / $1,311.62
| Facility | | $635.94 | $818.67 | $1,311.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.51 / $780.00 / $1,697.48
| Professional | | $589.51 | $780.00 | $1,697.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,947.88 / $1,947.88 / $1,947.88
| Professional | | $1,947.88 | $1,947.88 | $1,947.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.67 / $752.07 / $1,126.80
| Professional | | $595.67 | $752.07 | $1,126.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,698.00 / $7,106.00 / $16,148.00
| Facility | | $3,698.00 | $7,106.00 | $16,148.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.76 / $721.14 / $2,004.56
| Professional | | $480.76 | $721.14 | $2,004.56 |