- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,294.68 / $1,474.10 / $4,676.25
| Facility | | $1,294.68 | $1,474.10 | $4,676.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $926.13 / $1,169.98 / $1,666.98
| Professional | | $926.13 | $1,169.98 | $1,666.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.93 / $2,308.15 / $3,728.67
| Facility | | $1,201.93 | $2,308.15 | $3,728.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $978.03 / $1,890.96 / $6,397.70
| Professional | | $978.03 | $1,890.96 | $6,397.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,378.90 / $1,657.60 / $2,097.05
| Facility | | $1,378.90 | $1,657.60 | $2,097.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,264.81 / $1,264.81 / $1,264.81
| Professional | | $1,264.81 | $1,264.81 | $1,264.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.21 / $2,485.37 / $4,130.47
| Facility | | $1,426.21 | $2,485.37 | $4,130.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,216.31 / $2,069.65 / $3,363.14
| Professional | | $1,216.31 | $2,069.65 | $3,363.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.23 / $1,909.00 / $6,679.00
| Facility | | $941.23 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.79 / $715.99 / $1,670.68
| Professional | | $97.79 | $715.99 | $1,670.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,265.25 / $2,397.65 / $3,151.23
| Professional | | $1,265.25 | $2,397.65 | $3,151.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,627.57 / $2,627.57 / $2,843.62
| Facility | | $2,627.57 | $2,627.57 | $2,843.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,067.27 / $2,067.27 / $5,572.13
| Facility | | $2,067.27 | $2,067.27 | $5,572.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,146.33 / $1,933.44 / $6,397.70
| Professional | | $1,146.33 | $1,933.44 | $6,397.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,073.85 / $1,615.18 / $3,024.47
| Professional | | $1,073.85 | $1,615.18 | $3,024.47 |