- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,862.09 / $14,454.40
| Facility | | $977.24 | $1,862.09 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $912.01 / $2,089.30
| Professional | | $794.33 | $912.01 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,220.18 / $18,197.01
| Facility | | $6,606.93 | $11,220.18 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,737.80 / $4,073.80
| Professional | | $870.96 | $1,737.80 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,754.23 / $4,365.16
| Facility | | $2,344.23 | $2,754.23 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,754.23 / $3,090.30
| Professional | | $1,348.96 | $2,754.23 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $6,918.31 / $13,489.63
| Facility | | $977.24 | $6,918.31 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,238.72 / $2,754.23
| Professional | | $1,621.81 | $2,238.72 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,691.53 / $7,943.28
| Facility | | $977.24 | $2,691.53 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,584.89 / $6,760.83
| Professional | | $891.25 | $1,584.89 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $1,202.26
| Professional | | $32.36 | $33.11 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,041.74 / $2,818.38
| Professional | | $1,047.13 | $2,041.74 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $7,244.36 / $7,244.36
| Facility | | $2,344.23 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $4,365.16 / $6,606.93
| Professional | | $1,348.96 | $4,365.16 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Professional | | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,897.79 / $4,897.79
| Professional | | $2,137.96 | $4,897.79 | $4,897.79 |
- 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
- $831.76 / $1,445.44 / $3,890.45
| Professional | | $831.76 | $1,445.44 | $3,890.45 |