- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.87 / $2,107.00 / $7,316.00
| Facility | | $538.87 | $2,107.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.26 / $607.22 / $991.68
| Professional | | $520.26 | $607.22 | $991.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.45 / $2,141.52 / $4,277.00
| Facility | | $1,096.45 | $2,141.52 | $4,277.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.42 / $676.74 / $973.76
| Professional | | $537.42 | $676.74 | $973.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $548.27 / $553.83
| Facility | | $80.00 | $548.27 | $553.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.85 / $985.85 / $985.85
| Facility | | $985.85 | $985.85 | $985.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.28 / $776.34 / $1,195.68
| Professional | | $584.28 | $776.34 | $1,195.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,746.76 / $11,500.00 / $12,000.00
| Facility | | $2,746.76 | $11,500.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,232.39 / $4,711.60 / $5,495.48
| Professional | | $4,232.39 | $4,711.60 | $5,495.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.00 / $722.60 / $1,136.35
| Facility | | $557.00 | $722.60 | $1,136.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $735.34 / $879.89 / $1,121.84
| Professional | | $735.34 | $879.89 | $1,121.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $681.48 / $884.39 / $1,422.45
| Professional | | $681.48 | $884.39 | $1,422.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.00 / $730.37 / $1,170.33
| Facility | | $557.00 | $730.37 | $1,170.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $599.78 / $819.30 / $1,244.89
| Professional | | $599.78 | $819.30 | $1,244.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $1,058.00 / $2,693.00
| Facility | | $161.00 | $1,058.00 | $2,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.17 / $658.80 / $1,046.83
| Professional | | $480.17 | $658.80 | $1,046.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.40 / $606.05 / $847.35
| Professional | | $536.40 | $606.05 | $847.35 |