- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,287.30 / $5,020.42 / $10,015.70
| Facility | | $2,287.30 | $5,020.42 | $10,015.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,681.84 / $2,018.21 / $16,140.60
| Professional | | $1,681.84 | $2,018.21 | $16,140.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,527.09 / $5,799.45 / $9,187.14
| Facility | | $1,527.09 | $5,799.45 | $9,187.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,453.93 / $2,114.80 / $10,243.56
| Professional | | $1,453.93 | $2,114.80 | $10,243.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.50 / $4,405.43 / $7,342.38
| Facility | | $2,088.50 | $4,405.43 | $7,342.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,143.22 / $1,885.90 / $2,708.18
| Professional | | $1,143.22 | $1,885.90 | $2,708.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.02 / $2,510.21 / $5,020.42
| Facility | | $1,850.02 | $2,510.21 | $5,020.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,054.29 / $1,301.58 / $12,551.05
| Professional | | $1,054.29 | $1,301.58 | $12,551.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,054.29 / $1,301.58 / $1,506.13
| Professional | | $1,054.29 | $1,301.58 | $1,506.13 |