- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $3,553.00 / $12,040.00
| Facility | | $921.00 | $3,553.00 | $12,040.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $848.75 / $1,006.71 / $1,664.47
| Professional | | $848.75 | $1,006.71 | $1,664.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,573.19 / $4,407.29 / $8,650.34
| Facility | | $2,573.19 | $4,407.29 | $8,650.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $924.94 / $1,170.75 / $1,595.36
| Professional | | $924.94 | $1,170.75 | $1,595.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $898.47 / $918.19
| Facility | | $80.00 | $898.47 | $918.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,137.59 / $1,137.59 / $1,137.59
| Facility | | $1,137.59 | $1,137.59 | $1,137.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $959.90 / $1,338.31 / $1,957.97
| Professional | | $959.90 | $1,338.31 | $1,957.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,957.00
| Facility | | $55.00 | $55.00 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,243.84 / $7,387.20 / $8,635.28
| Professional | | $7,243.84 | $7,387.20 | $8,635.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.77 / $1,147.58 / $1,855.38
| Facility | | $934.77 | $1,147.58 | $1,855.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,234.83 / $1,481.79 / $1,837.42
| Professional | | $1,234.83 | $1,481.79 | $1,837.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,626.55 / $1,879.43 / $3,755.01
| Professional | | $1,626.55 | $1,879.43 | $3,755.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.66 / $1,150.05 / $1,933.74
| Facility | | $937.66 | $1,150.05 | $1,933.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $963.66 / $1,372.02 / $2,065.94
| Professional | | $963.66 | $1,372.02 | $2,065.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,134.00
| Facility | | $2,093.00 | $6,000.00 | $13,134.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $786.29 / $1,048.76 / $1,671.23
| Professional | | $786.29 | $1,048.76 | $1,671.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $843.11 / $958.70 / $1,328.44
| Professional | | $843.11 | $958.70 | $1,328.44 |