- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.29 / $3,633.00 / $8,294.00
| Facility | | $1,032.29 | $3,633.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.37 / $620.74 / $900.07
| Professional | | $505.37 | $620.74 | $900.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.86 / $710.94 / $1,175.39
| Professional | | $543.86 | $710.94 | $1,175.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.47 / $675.89 / $2,012.00
| Professional | | $603.47 | $675.89 | $2,012.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $679.25
| Facility | | $572.00 | $572.00 | $679.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.52 / $721.25 / $1,259.91
| Professional | | $558.52 | $721.25 | $1,259.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $574.51 / $738.52 / $872.79
| Professional | | $574.51 | $738.52 | $872.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.83 / $715.65 / $1,069.95
| Facility | | $545.83 | $715.65 | $1,069.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $681.00 / $786.48 / $1,112.00
| Professional | | $681.00 | $786.48 | $1,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.77 / $715.37 / $1,683.00
| Facility | | $520.77 | $715.37 | $1,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.77 / $715.37 / $1,683.00
| Professional | | $520.77 | $715.37 | $1,683.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,713.00 / $2,863.00 / $5,340.00
| Facility | | $1,713.00 | $2,863.00 | $5,340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.36 / $672.54 / $1,069.57
| Professional | | $427.36 | $672.54 | $1,069.57 |