- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,165.95 / $9,549.93
| Facility | | $1,071.52 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $4,073.80 / $8,912.51
| Professional | | $707.95 | $4,073.80 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Professional | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,621.81 / $10,471.29
| Professional | | $794.33 | $1,621.81 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,912.51 / $9,772.37
| Professional | | $6,918.31 | $8,912.51 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,888.44 / $9,332.54
| Professional | | $1,148.15 | $5,888.44 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $24,547.09 / $26,915.35
| Facility | | $18,620.87 | $24,547.09 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,495.41 / $9,772.37
| Facility | | $1,047.13 | $5,495.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $3,548.13 / $12,589.25
| Professional | | $776.25 | $3,548.13 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $12,882.50
| Facility | | $1,584.89 | $1,584.89 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $10,715.19 / $14,791.08
| Professional | | $1,348.96 | $10,715.19 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,949.84 / $5,495.41
| Facility | | $741.31 | $1,949.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,949.84 / $5,495.41
| Professional | | $741.31 | $1,949.84 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $8,128.31 / $29,512.09
| Facility | | $3,311.31 | $8,128.31 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,548.82 / $9,549.93
| Professional | | $758.58 | $1,548.82 | $9,549.93 |