- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,219.00 / $11,453.00
| Facility | | $803.00 | $3,219.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.87 / $901.67 / $1,481.12
| Professional | | $776.87 | $901.67 | $1,481.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,436.33 / $4,325.17 / $8,431.35
| Facility | | $2,436.33 | $4,325.17 | $8,431.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $824.90 / $1,044.13 / $1,422.81
| Professional | | $824.90 | $1,044.13 | $1,422.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $839.60 / $839.75
| Facility | | $80.00 | $839.60 | $839.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.54 / $996.54 / $996.54
| Facility | | $996.54 | $996.54 | $996.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $854.09 / $1,130.34 / $1,729.27
| Professional | | $854.09 | $1,130.34 | $1,729.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,255.92 / $11,500.00 / $26,542.00
| Facility | | $3,255.92 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,898.69 / $7,126.35 / $7,522.73
| Professional | | $6,898.69 | $7,126.35 | $7,522.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.99 / $1,118.13 / $1,734.79
| Facility | | $843.99 | $1,118.13 | $1,734.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,075.53 / $1,316.44 / $1,600.38
| Professional | | $1,075.53 | $1,316.44 | $1,600.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $856.89 / $1,485.16 / $3,250.37
| Professional | | $856.89 | $1,485.16 | $3,250.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.14 / $1,124.25 / $1,778.73
| Facility | | $849.14 | $1,124.25 | $1,778.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $867.37 / $1,162.05 / $1,783.76
| Professional | | $867.37 | $1,162.05 | $1,783.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.34 / $914.65 / $1,431.63
| Professional | | $680.34 | $914.65 | $1,431.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $734.34 / $827.44 / $1,161.41
| Professional | | $734.34 | $827.44 | $1,161.41 |