- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.68 / $5,328.00 / $9,347.59
| Facility | | $1,048.68 | $5,328.00 | $9,347.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.00 / $635.88 / $980.20
| Professional | | $549.00 | $635.88 | $980.20 |
- 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
- $563.32 / $720.37 / $1,190.98
| Professional | | $563.32 | $720.37 | $1,190.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.73 / $689.66 / $3,019.00
| Professional | | $657.73 | $689.66 | $3,019.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.92 / $688.92 / $776.00
| Facility | | $688.92 | $688.92 | $776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.83 / $793.85 / $1,309.74
| Professional | | $586.83 | $793.85 | $1,309.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.16 / $747.11 / $882.95
| Professional | | $583.16 | $747.11 | $882.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.32 / $793.55 / $1,163.66
| Facility | | $620.32 | $793.55 | $1,163.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $742.00 / $841.82 / $1,161.00
| Professional | | $742.00 | $841.82 | $1,161.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.69 / $772.86 / $2,602.61
| Facility | | $559.69 | $772.86 | $2,602.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.69 / $772.86 / $2,602.61
| Professional | | $559.69 | $772.86 | $2,602.61 |
- 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
- $464.15 / $737.86 / $1,125.16
| Professional | | $464.15 | $737.86 | $1,125.16 |