- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.27 / $1,376.39 / $7,920.26
| Facility | | $741.27 | $1,376.39 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.95 / $584.80 / $1,966.14
| Professional | | $318.95 | $584.80 | $1,966.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.00 / $736.00 / $736.00
| Facility | | $736.00 | $736.00 | $736.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.01 / $850.18 / $1,483.00
| Professional | | $498.01 | $850.18 | $1,483.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.07 / $901.14 / $1,357.33
| Professional | | $709.07 | $901.14 | $1,357.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.29 / $809.72 / $1,219.27
| Facility | | $471.29 | $809.72 | $1,219.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.58 / $848.40 / $1,258.03
| Professional | | $551.58 | $848.40 | $1,258.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.71 / $960.11 / $1,115.55
| Facility | | $585.71 | $960.11 | $1,115.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.29 / $812.60 / $1,429.59
| Facility | | $471.29 | $812.60 | $1,429.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.04 / $933.24 / $1,447.75
| Professional | | $622.04 | $933.24 | $1,447.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,868.81 / $5,124.10 / $6,421.06
| Facility | | $3,868.81 | $5,124.10 | $6,421.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $636.29 / $1,024.64 / $1,540.43
| Professional | | $636.29 | $1,024.64 | $1,540.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,689.00 / $5,130.00 / $7,385.00
| Facility | | $1,689.00 | $5,130.00 | $7,385.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $746.77 / $1,062.60 / $1,689.95
| Professional | | $746.77 | $1,062.60 | $1,689.95 |