- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,801.89 / $10,964.78
| Facility | | $1,288.25 | $3,801.89 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,122.02 / $3,235.94
| Professional | | $870.96 | $1,122.02 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,047.13 / $2,951.21
| Professional | | $812.83 | $1,047.13 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $37,153.52
| Facility | | $1,380.38 | $1,380.38 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Professional | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,698.24 / $50,118.72
| Facility | | $34.67 | $1,698.24 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,659.59 / $5,248.07
| Professional | | $954.99 | $1,659.59 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,621.81 / $3,981.07
| Facility | | $1,096.48 | $1,621.81 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,479.11 / $2,041.74
| Professional | | $1,122.02 | $1,479.11 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,258.93 / $2,089.30
| Professional | | $794.33 | $1,258.93 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $50,118.72 / $75,857.76
| Facility | | $977.24 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $1,348.96 / $2,089.30
| Professional | | $398.11 | $1,348.96 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $9,332.54
| Facility | | $1,513.56 | $4,168.69 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,380.38 / $3,548.13
| Professional | | $954.99 | $1,380.38 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,148.15 / $3,388.44
| Facility | | $794.33 | $1,148.15 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,148.15 / $2,511.89
| Professional | | $794.33 | $1,148.15 | $2,511.89 |