- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $844.01 / $3,682.00 / $12,941.00
| Facility | | $844.01 | $3,682.00 | $12,941.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.16 / $639.33 / $1,082.70
| Professional | | $560.16 | $639.33 | $1,082.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,485.14 / $9,092.56 / $18,185.13
| Facility | | $4,485.14 | $9,092.56 | $18,185.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.59 / $738.68 / $1,006.59
| Professional | | $583.59 | $738.68 | $1,006.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $580.97 / $589.16
| Facility | | $80.00 | $580.97 | $589.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $719.05 / $719.05 / $719.05
| Facility | | $719.05 | $719.05 | $719.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.09 / $834.11 / $1,282.08
| Professional | | $620.09 | $834.11 | $1,282.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,560.76 / $19,913.50 / $26,542.00
| Facility | | $3,560.76 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,586.32 / $4,673.04 / $5,467.88
| Professional | | $4,586.32 | $4,673.04 | $5,467.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.86 / $782.70 / $1,211.41
| Facility | | $604.86 | $782.70 | $1,211.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $781.58 / $937.89 / $1,162.98
| Professional | | $781.58 | $937.89 | $1,162.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $701.27 / $1,091.89 / $2,351.92
| Professional | | $701.27 | $1,091.89 | $2,351.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.85 / $792.50 / $1,277.25
| Facility | | $609.85 | $792.50 | $1,277.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.36 / $857.33 / $1,310.93
| Professional | | $637.36 | $857.33 | $1,310.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.00 / $666.90 / $1,050.01
| Professional | | $495.00 | $666.90 | $1,050.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.64 / $604.86 / $841.85
| Professional | | $533.64 | $604.86 | $841.85 |