- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $6,025.60 / $18,620.87
| Facility | | $1,348.96 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $812.83 / $1,862.09
| Professional | | $616.60 | $812.83 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $4,466.84
| Facility | | $707.95 | $870.96 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,148.15 / $2,137.96
| Professional | | $630.96 | $1,148.15 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,445.44 / $4,265.80
| Facility | | $741.31 | $1,445.44 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $1,380.38 / $2,818.38
| Professional | | $676.08 | $1,380.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $316.23
| Professional | | $32.36 | $33.11 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,348.96 / $1,412.54
| Facility | | $1,096.48 | $1,348.96 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $977.24 / $977.24
| Facility | | $933.25 | $977.24 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,513.56 / $2,041.74
| Professional | | $977.24 | $1,513.56 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $17,378.01
| Facility | | $6,165.95 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,348.96 / $1,819.70
| Professional | | $954.99 | $1,348.96 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $11,220.18 / $18,620.87
| Facility | | $2,454.71 | $11,220.18 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,023.29 / $1,905.46
| Professional | | $691.83 | $1,023.29 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $758.58 / $1,258.93
| Professional | | $660.69 | $758.58 | $1,258.93 |