- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.14 / $5,412.00 / $10,637.11
| Facility | | $1,123.14 | $5,412.00 | $10,637.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $585.63 / $676.54 / $989.52
| Professional | | $585.63 | $676.54 | $989.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,861.00 / $28,147.00 / $30,324.00
| Facility | | $21,861.00 | $28,147.00 | $30,324.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.82 / $768.32 / $1,270.26
| Professional | | $600.82 | $768.32 | $1,270.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $697.72 / $753.54 / $8,040.00
| Professional | | $697.72 | $753.54 | $8,040.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.30 / $734.30 / $900.00
| Facility | | $734.30 | $734.30 | $900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.72 / $815.57 / $1,402.11
| Professional | | $635.72 | $815.57 | $1,402.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.21 / $794.31 / $938.73
| Professional | | $620.21 | $794.31 | $938.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.43 / $848.74 / $1,238.07
| Facility | | $669.43 | $848.74 | $1,238.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.00 / $899.00 / $1,242.00
| Professional | | $794.00 | $899.00 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.72 / $810.72 / $2,786.27
| Facility | | $605.72 | $810.72 | $2,786.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.72 / $810.72 / $2,786.27
| Professional | | $605.72 | $810.72 | $2,786.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,423.00 / $11,475.00 / $21,639.00
| Facility | | $6,423.00 | $11,475.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.04 / $788.09 / $1,232.20
| Professional | | $506.04 | $788.09 | $1,232.20 |