- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.30 / $5,087.00 / $8,294.00
| Facility | | $1,060.30 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $854.12 / $965.85 / $1,183.18
| Professional | | $854.12 | $965.85 | $1,183.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $890.51 / $1,155.68 / $1,596.52
| Professional | | $890.51 | $1,155.68 | $1,596.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $931.41 / $1,056.20 / $4,284.00
| Professional | | $931.41 | $1,056.20 | $4,284.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.75 / $1,110.75 / $1,110.75
| Facility | | $1,110.75 | $1,110.75 | $1,110.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.07 / $1,088.57 / $1,908.63
| Professional | | $910.07 | $1,088.57 | $1,908.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,033.92 / $1,144.11 / $1,362.05
| Professional | | $1,033.92 | $1,144.11 | $1,362.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $855.52 / $1,092.10 / $1,534.58
| Facility | | $855.52 | $1,092.10 | $1,534.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,159.00 / $1,308.70 / $2,255.00
| Professional | | $1,159.00 | $1,308.70 | $2,255.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $925.62 / $1,176.38 / $7,030.19
| Facility | | $925.62 | $1,176.38 | $7,030.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $925.62 / $1,176.38 / $7,030.19
| Professional | | $925.62 | $1,176.38 | $7,030.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,270.00 / $17,192.00
| Facility | | $6,303.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $729.29 / $993.72 / $1,720.79
| Professional | | $729.29 | $993.72 | $1,720.79 |