- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,529.30 / $7,961.52 / $12,582.66
| Facility | | $3,529.30 | $7,961.52 | $12,582.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,321.98 / $2,554.17 / $2,556.33
| Professional | | $2,321.98 | $2,554.17 | $2,556.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.02 / $8,459.92 / $79,506.39
| Facility | | $847.02 | $8,459.92 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,082.55 / $1,123.40 / $1,841.75
| Professional | | $1,082.55 | $1,123.40 | $1,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,170.71 / $3,097.68 / $6,507.00
| Facility | | $1,170.71 | $3,097.68 | $6,507.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,613.31 / $2,700.51 / $5,597.18
| Professional | | $1,613.31 | $2,700.51 | $5,597.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,124.98 / $1,536.30 / $1,717.83
| Professional | | $1,124.98 | $1,536.30 | $1,717.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,884.03 / $4,088.63 / $12,775.50
| Facility | | $3,884.03 | $4,088.63 | $12,775.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,529.30 / $7,961.52 / $12,954.36
| Facility | | $3,529.30 | $7,961.52 | $12,954.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,176.08 / $2,554.17 / $2,556.33
| Professional | | $2,176.08 | $2,554.17 | $2,556.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,649.10 / $2,559.16 / $2,770.25
| Professional | | $1,649.10 | $2,559.16 | $2,770.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,135.20 / $2,762.23 / $5,752.97
| Facility | | $1,135.20 | $2,762.23 | $5,752.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,613.31 / $2,700.51 / $5,597.18
| Professional | | $1,613.31 | $2,700.51 | $5,597.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.08 / $1,058.51 / $1,058.51
| Facility | | $924.08 | $1,058.51 | $1,058.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $924.08 / $1,058.51 / $1,199.44
| Professional | | $924.08 | $1,058.51 | $1,199.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,759.44 / $3,332.93 / $4,334.22
| Facility | | $1,759.44 | $3,332.93 | $4,334.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $919.14 / $1,225.52 / $1,937.07
| Professional | | $919.14 | $1,225.52 | $1,937.07 |