- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,088.00 / $3,645.00 / $8,294.00
| Facility | | $1,088.00 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $693.21 / $806.42 / $1,068.44
| Professional | | $693.21 | $806.42 | $1,068.44 |
- 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
- $707.71 / $915.69 / $1,513.91
| Professional | | $707.71 | $915.69 | $1,513.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $810.00 / $875.51 / $1,567.64
| Professional | | $810.00 | $875.51 | $1,567.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $874.54
| Facility | | $572.00 | $572.00 | $874.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $746.28 / $989.18 / $1,665.73
| Professional | | $746.28 | $989.18 | $1,665.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $738.89 / $947.09 / $1,119.29
| Professional | | $738.89 | $947.09 | $1,119.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.92 / $1,011.15 / $1,475.75
| Facility | | $786.92 | $1,011.15 | $1,475.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $943.00 / $1,071.00 / $1,476.00
| Professional | | $943.00 | $1,071.00 | $1,476.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.14 / $960.57 / $3,242.16
| Facility | | $741.14 | $960.57 | $3,242.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.14 / $960.57 / $3,242.16
| Professional | | $741.14 | $960.57 | $3,242.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $9,270.00 / $17,192.00
| Facility | | $5,121.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $585.98 / $907.97 / $1,465.65
| Professional | | $585.98 | $907.97 | $1,465.65 |