- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,162.38 / $5,360.00 / $9,347.59
| Facility | | $1,162.38 | $5,360.00 | $9,347.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.16 / $702.70 / $947.54
| Professional | | $645.16 | $702.70 | $947.54 |
- 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
- $622.94 / $796.61 / $1,317.03
| Professional | | $622.94 | $796.61 | $1,317.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.67 / $760.88 / $6,433.00
| Professional | | $715.67 | $760.88 | $6,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.31 / $763.31 / $776.00
| Facility | | $763.31 | $763.31 | $776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.34 / $960.35 / $1,458.54
| Professional | | $662.34 | $960.35 | $1,458.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $646.19 / $827.12 / $976.14
| Professional | | $646.19 | $827.12 | $976.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.75 / $895.85 / $1,370.40
| Facility | | $695.75 | $895.85 | $1,370.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $823.00 / $995.00 / $1,300.00
| Professional | | $823.00 | $995.00 | $1,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.18 / $917.27 / $2,898.44
| Facility | | $665.18 | $917.27 | $2,898.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.18 / $917.27 / $2,898.44
| Professional | | $665.18 | $917.27 | $2,898.44 |
- 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
- $547.29 / $882.51 / $1,458.73
| Professional | | $547.29 | $882.51 | $1,458.73 |