- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.73 / $956.59 / $7,278.00
| Facility | | $580.73 | $956.59 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $580.73 / $697.30 / $1,159.01
| Professional | | $580.73 | $697.30 | $1,159.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.58 / $1,301.58 / $1,320.58
| Facility | | $1,301.58 | $1,301.58 | $1,320.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.20 / $1,016.39 / $1,796.44
| Professional | | $621.20 | $1,016.39 | $1,796.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,128.25
| Facility | | $530.04 | $530.04 | $1,128.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.13 / $851.27 / $1,579.16
| Professional | | $555.13 | $851.27 | $1,579.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.00 / $734.30 / $1,242.86
| Facility | | $415.00 | $734.30 | $1,242.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $924.00 / $924.00
| Professional | | $507.00 | $924.00 | $924.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $946.10 / $2,020.80
| Professional | | $5.00 | $946.10 | $2,020.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.00 / $3,445.00 / $6,097.00
| Facility | | $1,064.00 | $3,445.00 | $6,097.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.89 / $794.74 / $1,641.86
| Professional | | $565.89 | $794.74 | $1,641.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,055.28 / $4,055.28 / $16,394.00
| Facility | | $4,055.28 | $4,055.28 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,268.32 / $5,117.68 / $5,961.68
| Professional | | $4,268.32 | $5,117.68 | $5,961.68 |