- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.52 / $8,584.52 / $33,222.10
| Facility | | $8,584.52 | $8,584.52 | $33,222.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,850.51 / $9,089.49 / $10,674.92
| Professional | | $6,850.51 | $9,089.49 | $10,674.92 |
- 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
- $14,637.45 / $19,223.07 / $19,223.07
| Professional | | $14,637.45 | $19,223.07 | $19,223.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,562.99 / $12,562.99 / $17,505.43
| Facility | | $12,562.99 | $12,562.99 | $17,505.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,170.98 / $9,170.98 / $15,328.38
| Professional | | $9,170.98 | $9,170.98 | $15,328.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,105.00 / $17,505.43 / $33,260.33
| Professional | | $16,105.00 | $17,505.43 | $33,260.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.52 / $8,584.52 / $33,222.10
| Facility | | $8,584.52 | $8,584.52 | $33,222.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,850.51 / $9,089.49 / $12,245.34
| Professional | | $6,850.51 | $9,089.49 | $12,245.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,857.10 / $23,875.10 / $34,488.90
| Professional | | $11,857.10 | $23,875.10 | $34,488.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,562.99 / $12,562.99 / $17,505.43
| Facility | | $12,562.99 | $12,562.99 | $17,505.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,170.98 / $9,170.98 / $22,514.25
| Professional | | $9,170.98 | $9,170.98 | $22,514.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,185.76 / $9,185.76 / $18,296.81
| Facility | | $9,185.76 | $9,185.76 | $18,296.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,185.76 / $18,296.81 / $18,484.83
| Professional | | $9,185.76 | $18,296.81 | $18,484.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,667.75 / $10,834.69 / $16,795.59
| Professional | | $8,667.75 | $10,834.69 | $16,795.59 |