- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,080.39 / $1,339.73 / $2,101.82
| Facility | | $1,080.39 | $1,339.73 | $2,101.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,050.14 / $1,237.84 / $2,036.14
| Professional | | $1,050.14 | $1,237.84 | $2,036.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,248.75 / $1,586.69 / $2,202.14
| Professional | | $1,248.75 | $1,586.69 | $2,202.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.77 / $1,233.77 / $1,233.77
| Facility | | $1,233.77 | $1,233.77 | $1,233.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,294.26 / $1,700.96 / $2,463.50
| Professional | | $1,294.26 | $1,700.96 | $2,463.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $12,370.08
| Facility | | $55.00 | $55.00 | $12,370.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,621.44 / $9,925.36 / $12,063.53
| Professional | | $9,621.44 | $9,925.36 | $12,063.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.45 / $1,622.19 / $2,864.35
| Facility | | $1,262.45 | $1,622.19 | $2,864.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,483.74 / $2,063.73 / $2,427.92
| Professional | | $1,483.74 | $2,063.73 | $2,427.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,138.90 / $1,138.90 / $1,138.90
| Professional | | $1,138.90 | $1,138.90 | $1,138.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.85 / $1,630.25 / $2,931.91
| Facility | | $1,272.85 | $1,630.25 | $2,931.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,300.50 / $1,740.44 / $2,684.33
| Professional | | $1,300.50 | $1,740.44 | $2,684.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,062.72 / $1,444.53 / $2,238.05
| Professional | | $1,062.72 | $1,444.53 | $2,238.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,151.20 / $1,313.64 / $1,797.69
| Professional | | $1,151.20 | $1,313.64 | $1,797.69 |