- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,550.67 / $10,061.00 / $20,509.00
| Facility | | $2,550.67 | $10,061.00 | $20,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,079.09 / $2,454.16 / $12,778.20
| Professional | | $2,079.09 | $2,454.16 | $12,778.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,734.00 / $12,567.00 / $28,484.71
| Facility | | $4,734.00 | $12,567.00 | $28,484.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,376.97 / $4,262.18 / $8,329.35
| Professional | | $3,376.97 | $4,262.18 | $8,329.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.50 / $100.00 / $11,798.98
| Facility | | $63.50 | $100.00 | $11,798.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,793.57 / $2,797.48 / $6,784.30
| Professional | | $1,793.57 | $2,797.48 | $6,784.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,362.25 / $3,132.40 / $9,067.56
| Professional | | $2,362.25 | $3,132.40 | $9,067.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,770.29 / $2,678.96 / $3,296.89
| Professional | | $1,770.29 | $2,678.96 | $3,296.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,441.73 / $3,159.52 / $5,568.66
| Professional | | $2,441.73 | $3,159.52 | $5,568.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $26,856.12 / $34,188.24
| Facility | | $55.00 | $26,856.12 | $34,188.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,559.75 / $18,098.00 / $20,348.48
| Professional | | $17,559.75 | $18,098.00 | $20,348.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,499.19 / $3,157.50 / $4,592.70
| Facility | | $2,499.19 | $3,157.50 | $4,592.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,362.25 / $3,190.08 / $6,952.62
| Professional | | $2,362.25 | $3,190.08 | $6,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,928.67 / $7,928.67 / $7,928.67
| Professional | | $7,928.67 | $7,928.67 | $7,928.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,770.29 / $2,655.43 / $3,348.71
| Professional | | $1,770.29 | $2,655.43 | $3,348.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,009.00 / $5,159.00 / $20,279.00
| Facility | | $2,009.00 | $5,159.00 | $20,279.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,023.62 / $2,908.37 / $8,215.10
| Professional | | $2,023.62 | $2,908.37 | $8,215.10 |