- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.48 / $2,012.00 / $6,827.70
| Facility | | $622.48 | $2,012.00 | $6,827.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.18 / $601.42 / $890.71
| Professional | | $496.18 | $601.42 | $890.71 |
- 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
- $511.49 / $661.81 / $1,094.17
| Professional | | $511.49 | $661.81 | $1,094.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591.00 / $636.32 / $2,012.00
| Professional | | $591.00 | $636.32 | $2,012.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.00 / $420.00 / $938.84
| Facility | | $420.00 | $420.00 | $938.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.28 / $705.82 / $1,254.50
| Professional | | $540.28 | $705.82 | $1,254.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.37 / $733.18 / $866.49
| Professional | | $568.37 | $733.18 | $866.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.59 / $703.67 / $1,064.14
| Facility | | $535.59 | $703.67 | $1,064.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $698.00 / $783.00 / $1,111.00
| Professional | | $698.00 | $783.00 | $1,111.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.17 / $674.11 / $1,289.34
| Facility | | $530.17 | $674.11 | $1,289.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.34 / $713.64 / $1,364.68
| Professional | | $558.34 | $713.64 | $1,364.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.00 / $1,045.00 / $2,364.00
| Facility | | $231.00 | $1,045.00 | $2,364.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.15 / $719.80 / $1,115.61
| Professional | | $434.15 | $719.80 | $1,115.61 |