- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,241.56 / $5,040.00 / $10,637.11
| Facility | | $1,241.56 | $5,040.00 | $10,637.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.07 / $748.00 / $999.85
| Professional | | $645.07 | $748.00 | $999.85 |
- 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
- $664.74 / $850.06 / $1,405.40
| Professional | | $664.74 | $850.06 | $1,405.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $749.55 / $811.30 / $5,146.00
| Professional | | $749.55 | $811.30 | $5,146.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $811.30 / $811.30 / $900.00
| Facility | | $811.30 | $811.30 | $900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $702.34 / $938.07 / $1,555.35
| Professional | | $702.34 | $938.07 | $1,555.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $685.21 / $877.07 / $1,036.49
| Professional | | $685.21 | $877.07 | $1,036.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.65 / $940.58 / $1,400.16
| Facility | | $741.65 | $940.58 | $1,400.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $863.00 / $999.85 / $1,378.00
| Professional | | $863.00 | $999.85 | $1,378.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.64 / $895.66 / $3,090.97
| Facility | | $687.64 | $895.66 | $3,090.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.64 / $895.66 / $3,090.97
| Professional | | $687.64 | $895.66 | $3,090.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,061.00 / $8,168.00 / $17,187.00
| Facility | | $5,061.00 | $8,168.00 | $17,187.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.21 / $867.32 / $1,366.39
| Professional | | $550.21 | $867.32 | $1,366.39 |