- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $7,244.36 / $34,673.69
| Facility | | $1,348.96 | $7,244.36 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $2,754.23 / $10,000.00
| Professional | | $776.25 | $2,754.23 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,220.18 / $19,054.61
| Facility | | $5,011.87 | $11,220.18 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,623.41 / $6,918.31 / $16,982.44
| Professional | | $5,623.41 | $6,918.31 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,265.80 / $28,183.83
| Facility | | $1,071.52 | $4,265.80 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $8,912.51
| Professional | | $1,071.52 | $1,071.52 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,311.31 / $50,118.72
| Facility | | $1,318.26 | $3,311.31 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $4,897.79 / $22,387.21
| Professional | | $794.33 | $4,897.79 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,862.09 / $3,090.30
| Facility | | $794.33 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,762.47 / $11,748.98
| Professional | | $6,025.60 | $7,762.47 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,762.47 / $14,125.38
| Professional | | $3,890.45 | $7,762.47 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $50,118.72 / $75,857.76
| Facility | | $1,258.93 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $7,943.28 / $13,182.57
| Professional | | $398.11 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $8,128.31 / $19,952.62
| Facility | | $2,818.38 | $8,128.31 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $3,630.78 / $12,589.25
| Professional | | $660.69 | $3,630.78 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,023.29 / $3,890.45
| Facility | | $616.60 | $1,023.29 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,888.44 / $11,220.18
| Professional | | $1,949.84 | $5,888.44 | $11,220.18 |