- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,007.84 / $5,360.00 / $9,347.59
| Facility | | $1,007.84 | $5,360.00 | $9,347.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.85 / $609.76 / $805.58
| Professional | | $517.85 | $609.76 | $805.58 |
- 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
- $537.91 / $691.29 / $1,142.90
| Professional | | $537.91 | $691.29 | $1,142.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.29 / $661.49 / $5,113.00
| Professional | | $623.29 | $661.49 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.27 / $660.27 / $776.00
| Facility | | $660.27 | $660.27 | $776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $563.47 / $743.82 / $1,256.40
| Professional | | $563.47 | $743.82 | $1,256.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.98 / $715.64 / $845.75
| Professional | | $557.98 | $715.64 | $845.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.70 / $750.96 / $1,087.52
| Facility | | $584.70 | $750.96 | $1,087.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $710.00 / $805.57 / $1,110.00
| Professional | | $710.00 | $805.57 | $1,110.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.45 / $725.39 / $2,496.53
| Facility | | $559.45 | $725.39 | $2,496.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.45 / $725.39 / $2,496.53
| Professional | | $559.45 | $725.39 | $2,496.53 |
- 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
- $441.98 / $683.60 / $1,110.96
| Professional | | $441.98 | $683.60 | $1,110.96 |