- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,852.79 / $8,123.58 / $12,049.98
| Facility | | $7,852.79 | $8,123.58 | $12,049.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,505.56 / $9,071.33 / $12,726.94
| Professional | | $6,505.56 | $9,071.33 | $12,726.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,223.43 / $2,185.62 / $4,483.93
| Facility | | $1,223.43 | $2,185.62 | $4,483.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $735.86 / $735.86 / $735.86
| Professional | | $735.86 | $735.86 | $735.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,159.67 / $1,159.67 / $1,159.67
| Facility | | $1,159.67 | $1,159.67 | $1,159.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,613.42 / $14,613.42 / $14,613.42
| Facility | | $14,613.42 | $14,613.42 | $14,613.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,777.03 / $10,777.03 / $10,777.03
| Professional | | $10,777.03 | $10,777.03 | $10,777.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,417.76 / $69,378.71 / $71,908.16
| Facility | | $21,417.76 | $69,378.71 | $71,908.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67,309.53 / $67,309.53 / $110,876.63
| Professional | | $67,309.53 | $67,309.53 | $110,876.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,546.22 / $8,123.58 / $14,762.94
| Facility | | $1,546.22 | $8,123.58 | $14,762.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,468.91 / $1,546.22 / $12,940.16
| Professional | | $1,468.91 | $1,546.22 | $12,940.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,546.22 / $7,455.22 / $14,762.94
| Facility | | $1,546.22 | $7,455.22 | $14,762.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,811.98 / $10,777.03 / $10,777.03
| Professional | | $1,811.98 | $10,777.03 | $10,777.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,422.83 / $6,498.28 / $9,406.79
| Professional | | $5,422.83 | $6,498.28 | $9,406.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,671.03 / $6,671.03 / $7,795.14
| Professional | | $6,671.03 | $6,671.03 | $7,795.14 |