- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.74 / $4,962.67 / $15,341.00
| Facility | | $854.74 | $4,962.67 | $15,341.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.71 / $467.30 / $950.31
| Professional | | $332.71 | $467.30 | $950.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.79 / $880.59 / $1,346.21
| Professional | | $570.79 | $880.59 | $1,346.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.01 / $900.38 / $1,176.22
| Professional | | $619.01 | $900.38 | $1,176.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.17 / $718.66 / $1,160.09
| Facility | | $495.17 | $718.66 | $1,160.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.84 / $834.73 / $1,238.13
| Professional | | $622.84 | $834.73 | $1,238.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.37 / $972.17 / $1,800.51
| Facility | | $650.37 | $972.17 | $1,800.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.17 / $776.15 / $3,005.10
| Facility | | $495.17 | $776.15 | $3,005.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $710.52 / $948.75 / $1,283.38
| Professional | | $710.52 | $948.75 | $1,283.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,536.02 / $8,364.56 / $10,637.18
| Facility | | $6,536.02 | $8,364.56 | $10,637.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $725.12 / $997.30 / $1,433.57
| Professional | | $725.12 | $997.30 | $1,433.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $9,074.00 / $12,786.00
| Facility | | $1,981.00 | $9,074.00 | $12,786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.29 / $947.06 / $1,505.97
| Professional | | $657.29 | $947.06 | $1,505.97 |