- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,349.50 / $5,360.00 / $10,081.83
| Facility | | $1,349.50 | $5,360.00 | $10,081.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $664.12 / $782.90 / $1,166.31
| Professional | | $664.12 | $782.90 | $1,166.31 |
- 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
- $691.48 / $903.90 / $1,494.41
| Professional | | $691.48 | $903.90 | $1,494.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $778.50 / $876.35 / $5,113.00
| Professional | | $778.50 | $876.35 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.00 / $776.00 / $857.48
| Facility | | $776.00 | $776.00 | $857.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $721.71 / $944.66 / $1,644.74
| Professional | | $721.71 | $944.66 | $1,644.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $722.06 / $934.43 / $1,104.32
| Professional | | $722.06 | $934.43 | $1,104.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.01 / $923.76 / $1,432.71
| Facility | | $735.01 | $923.76 | $1,432.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $868.00 / $1,006.60 / $1,418.00
| Professional | | $868.00 | $1,006.60 | $1,418.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.32 / $938.22 / $3,151.59
| Facility | | $713.32 | $938.22 | $3,151.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $713.32 / $938.22 / $3,151.59
| Professional | | $713.32 | $938.22 | $3,151.59 |
- 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
- $567.23 / $929.81 / $1,415.23
| Professional | | $567.23 | $929.81 | $1,415.23 |