- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.24 / $5,087.00 / $8,920.00
| Facility | | $1,051.24 | $5,087.00 | $8,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.58 / $635.89 / $924.51
| Professional | | $540.58 | $635.89 | $924.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.25 / $721.55 / $1,192.93
| Professional | | $564.25 | $721.55 | $1,192.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $653.46 / $705.74 / $5,113.00
| Professional | | $653.46 | $705.74 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $688.92
| Facility | | $640.00 | $640.00 | $688.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $596.83 / $869.05 / $1,309.56
| Professional | | $596.83 | $869.05 | $1,309.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.28 / $746.96 / $882.77
| Professional | | $582.28 | $746.96 | $882.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.89 / $824.39 / $1,229.31
| Facility | | $635.89 | $824.39 | $1,229.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $731.00 / $858.00 / $1,162.00
| Professional | | $731.00 | $858.00 | $1,162.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.10 / $816.48 / $2,602.21
| Facility | | $595.10 | $816.48 | $2,602.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.10 / $816.48 / $2,602.21
| Professional | | $595.10 | $816.48 | $2,602.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $9,270.00 / $17,192.00
| Facility | | $5,121.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.39 / $821.94 / $1,202.79
| Professional | | $491.39 | $821.94 | $1,202.79 |