- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $3,224.00 / $11,453.00
| Facility | | $767.00 | $3,224.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.35 / $636.11 / $1,038.82
| Professional | | $557.35 | $636.11 | $1,038.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.90 / $4,379.92 / $8,568.21
| Facility | | $2,575.90 | $4,379.92 | $8,568.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.94 / $734.01 / $1,000.22
| Professional | | $575.94 | $734.01 | $1,000.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $578.01 / $586.14
| Facility | | $80.00 | $578.01 | $586.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.96 / $714.96 / $714.96
| Facility | | $714.96 | $714.96 | $714.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $617.51 / $823.29 / $1,251.21
| Professional | | $617.51 | $823.29 | $1,251.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,950.20 / $11,500.00 / $26,542.00
| Facility | | $2,950.20 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,561.12 / $4,648.39 / $5,435.85
| Professional | | $4,561.12 | $4,648.39 | $5,435.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.15 / $740.28 / $1,168.68
| Facility | | $593.15 | $740.28 | $1,168.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $777.13 / $932.55 / $1,156.35
| Professional | | $777.13 | $932.55 | $1,156.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.70 / $1,048.79 / $1,100.20
| Professional | | $706.70 | $1,048.79 | $1,100.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.15 / $753.15 / $1,225.40
| Facility | | $593.15 | $753.15 | $1,225.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.44 / $846.06 / $1,295.25
| Professional | | $631.44 | $846.06 | $1,295.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.05 / $652.79 / $1,021.83
| Professional | | $485.05 | $652.79 | $1,021.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.60 / $601.39 / $837.11
| Professional | | $530.60 | $601.39 | $837.11 |