- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,596.25 / $20,520.09 / $38,866.01
| Facility | | $17,596.25 | $20,520.09 | $38,866.01 |
- 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
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,228.38 / $1,274.73 / $2,016.35
| Professional | | $1,228.38 | $1,274.73 | $2,016.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,352.45 / $4,721.67 / $25,034.68
| Facility | | $1,352.45 | $4,721.67 | $25,034.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,922.63 / $3,218.28 / $5,218.32
| Professional | | $1,922.63 | $3,218.28 | $5,218.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,300.55 / $1,492.37 / $1,939.94
| Professional | | $1,300.55 | $1,492.37 | $1,939.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,050.09 / $21,637.50 / $42,897.18
| Facility | | $5,050.09 | $21,637.50 | $42,897.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,005.94 / $21,879.00 / $38,866.01
| Facility | | $8,005.94 | $21,879.00 | $38,866.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $975.66 / $1,381.10 / $1,584.90
| Professional | | $975.66 | $1,381.10 | $1,584.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,520.90 / $3,238.55 / $3,505.56
| Professional | | $1,520.90 | $3,238.55 | $3,505.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,327.26 / $3,934.72 / $25,034.68
| Facility | | $1,327.26 | $3,934.72 | $25,034.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,922.63 / $3,218.28 / $5,218.32
| Professional | | $1,922.63 | $3,218.28 | $5,218.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,158.84 / $1,158.84 / $1,158.84
| Facility | | $1,158.84 | $1,158.84 | $1,158.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,073.75 / $1,182.03 / $7,003.44
| Professional | | $1,073.75 | $1,182.03 | $7,003.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,006.27 / $1,453.50 / $2,345.13
| Professional | | $1,006.27 | $1,453.50 | $2,345.13 |