- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.52 / $996.80 / $6,190.74
| Facility | | $965.52 | $996.80 | $6,190.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.65 / $1,216.55 / $5,066.67
| Professional | | $910.65 | $1,216.55 | $5,066.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $9,557.00 / $19,252.00
| Facility | | $3,028.00 | $9,557.00 | $19,252.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,176.45 / $1,632.40 / $3,150.79
| Professional | | $1,176.45 | $1,632.40 | $3,150.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.20 / $100.00 / $7,121.41
| Facility | | $64.20 | $100.00 | $7,121.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,037.43 / $1,482.04 / $3,612.77
| Professional | | $1,037.43 | $1,482.04 | $3,612.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $994.21 / $1,382.28 / $3,694.50
| Professional | | $994.21 | $1,382.28 | $3,694.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,197.35 / $1,317.10 / $1,556.57
| Professional | | $1,197.35 | $1,317.10 | $1,556.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,105.16 / $1,461.54 / $2,540.80
| Professional | | $1,105.16 | $1,461.54 | $2,540.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,551.58 / $8,033.82
| Facility | | $55.00 | $6,551.58 | $8,033.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,092.80 / $8,326.08 / $10,178.85
| Professional | | $8,092.80 | $8,326.08 | $10,178.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.96 / $1,385.89 / $1,907.01
| Facility | | $1,030.96 | $1,385.89 | $1,907.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,010.27 / $1,426.34 / $3,146.77
| Professional | | $1,010.27 | $1,426.34 | $3,146.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,571.43 / $3,571.43 / $3,571.43
| Professional | | $3,571.43 | $3,571.43 | $3,571.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,836.00 / $5,123.00 / $20,279.00
| Facility | | $1,836.00 | $5,123.00 | $20,279.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.21 / $1,310.33 / $3,482.31
| Professional | | $954.21 | $1,310.33 | $3,482.31 |