- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $888.48 / $5,030.14 / $12,282.68
| Facility | | $888.48 | $5,030.14 | $12,282.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $636.57 / $1,455.61 / $2,703.69
| Professional | | $636.57 | $1,455.61 | $2,703.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,514.95 / $1,572.12 / $1,572.12
| Professional | | $1,514.95 | $1,572.12 | $1,572.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $719.49 / $1,401.62 / $3,357.48
| Professional | | $719.49 | $1,401.62 | $3,357.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,832.59 / $2,428.86 / $2,496.44
| Professional | | $1,832.59 | $2,428.86 | $2,496.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,612.53 / $10,459.12 / $18,386.47
| Facility | | $7,612.53 | $10,459.12 | $18,386.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,993.00 / $11,640.00
| Facility | | $1,020.00 | $4,993.00 | $11,640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $674.02 / $1,455.61 / $3,011.23
| Professional | | $674.02 | $1,455.61 | $3,011.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $956.50 / $4,411.60
| Professional | | $5.00 | $956.50 | $4,411.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.31 / $1,401.62 / $3,430.35
| Professional | | $728.31 | $1,401.62 | $3,430.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.51 / $1,555.56 / $7,187.12
| Facility | | $672.51 | $1,555.56 | $7,187.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.51 / $1,531.60 / $1,805.00
| Professional | | $672.51 | $1,531.60 | $1,805.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,572.12 / $2,136.02 / $3,695.36
| Professional | | $1,572.12 | $2,136.02 | $3,695.36 |