- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,209.77 / $19,591.00 / $48,543.24
| Facility | | $1,209.77 | $19,591.00 | $48,543.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $975.66 / $1,381.10 / $1,381.10
| Professional | | $975.66 | $1,381.10 | $1,381.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,319.53 / $4,825.14 / $19,253.59
| Facility | | $1,319.53 | $4,825.14 | $19,253.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,132.66 / $1,776.30 / $17,540.00
| Professional | | $1,132.66 | $1,776.30 | $17,540.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,679.56 / $14,747.13 / $25,831.52
| Facility | | $5,679.56 | $14,747.13 | $25,831.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,949.29 / $42,343.00 / $56,064.00
| Facility | | $8,949.29 | $42,343.00 | $56,064.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,065.67 / $2,065.67 / $2,065.67
| Professional | | $2,065.67 | $2,065.67 | $2,065.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.97 / $1,979.30 / $6,991.73
| Facility | | $1,233.97 | $1,979.30 | $6,991.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,388.21 / $1,754.17 / $2,673.90
| Professional | | $1,388.21 | $1,754.17 | $2,673.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,370.52 / $2,569.71 / $3,585.12
| Professional | | $1,370.52 | $2,569.71 | $3,585.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,200.48 / $10,200.48 / $10,200.48
| Facility | | $10,200.48 | $10,200.48 | $10,200.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,244.21 / $1,950.38 / $17,540.00
| Professional | | $1,244.21 | $1,950.38 | $17,540.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,190.55 / $1,572.42 / $3,332.12
| Professional | | $1,190.55 | $1,572.42 | $3,332.12 |