- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,056.00 / $2,747.00 / $8,017.00
| Facility | | $1,056.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.18 / $1,069.07 / $1,935.01
| Professional | | $907.18 | $1,069.07 | $1,935.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,049.17 / $1,088.76 / $1,945.16
| Professional | | $1,049.17 | $1,088.76 | $1,945.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.76 / $1,191.76 / $1,191.76
| Facility | | $1,191.76 | $1,191.76 | $1,191.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $979.01 / $1,295.83 / $2,110.98
| Professional | | $979.01 | $1,295.83 | $2,110.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,234.67 / $1,673.96 / $2,132.62
| Professional | | $1,234.67 | $1,673.96 | $2,132.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,373.76 / $15,373.76 / $27,600.80
| Facility | | $15,373.76 | $15,373.76 | $27,600.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,177.34 / $1,286.53 / $1,286.53
| Professional | | $1,177.34 | $1,286.53 | $1,286.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,077.00 / $8,017.00
| Facility | | $1,013.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.18 / $1,165.10 / $3,175.13
| Professional | | $907.18 | $1,165.10 | $3,175.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,145.80 / $1,145.80 / $2,151.69
| Professional | | $1,145.80 | $1,145.80 | $2,151.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.76 / $1,191.76 / $1,191.76
| Facility | | $1,191.76 | $1,191.76 | $1,191.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $984.25 / $1,327.40 / $2,122.06
| Professional | | $984.25 | $1,327.40 | $2,122.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $982.30 / $1,029.41 / $1,029.41
| Facility | | $982.30 | $1,029.41 | $1,029.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $982.30 / $1,029.41 / $1,087.53
| Professional | | $982.30 | $1,029.41 | $1,087.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $988.71 / $1,318.67 / $1,910.57
| Professional | | $988.71 | $1,318.67 | $1,910.57 |