- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.94 / $513.01 / $743.66
| Professional | | $459.94 | $513.01 | $743.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.57 / $527.76 / $527.76
| Professional | | $508.57 | $527.76 | $527.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.10 / $576.10 / $576.10
| Facility | | $576.10 | $576.10 | $576.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.65 / $640.61 / $1,032.61
| Professional | | $490.65 | $640.61 | $1,032.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.15 / $823.49 / $1,038.34
| Professional | | $601.15 | $823.49 | $1,038.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,853.46 / $6,853.46 / $6,853.46
| Facility | | $6,853.46 | $6,853.46 | $6,853.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,077.00 / $8,017.00
| Facility | | $954.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.94 / $547.41 / $2,617.39
| Professional | | $459.94 | $547.41 | $2,617.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.10 / $687.10 / $1,036.40
| Professional | | $687.10 | $687.10 | $1,036.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.10 / $576.10 / $576.10
| Facility | | $576.10 | $576.10 | $576.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.65 / $643.40 / $1,076.45
| Professional | | $490.65 | $643.40 | $1,076.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.06 / $496.06 / $529.54
| Facility | | $496.06 | $496.06 | $529.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.82 / $501.53 / $529.54
| Professional | | $477.82 | $501.53 | $529.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.54 / $615.16 / $998.35
| Professional | | $474.54 | $615.16 | $998.35 |