- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $3,224.00 / $11,453.00
| Facility | | $767.00 | $3,224.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.73 / $687.09 / $1,135.02
| Professional | | $588.73 | $687.09 | $1,135.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,135.21 / $4,297.80 / $8,212.35
| Facility | | $2,135.21 | $4,297.80 | $8,212.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $634.67 / $803.36 / $1,076.58
| Professional | | $634.67 | $803.36 | $1,076.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $620.66 / $620.66
| Facility | | $80.00 | $620.66 | $620.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.76 / $768.76 / $768.76
| Facility | | $768.76 | $768.76 | $768.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.48 / $843.28 / $1,315.48
| Professional | | $644.48 | $843.28 | $1,315.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,499.76 / $11,500.00 / $26,542.00
| Facility | | $2,499.76 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,888.64 / $5,057.35 / $5,759.70
| Professional | | $4,888.64 | $5,057.35 | $5,759.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.58 / $828.28 / $1,285.08
| Facility | | $639.58 | $828.28 | $1,285.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $827.26 / $992.72 / $1,230.97
| Professional | | $827.26 | $992.72 | $1,230.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $844.10 / $844.10 / $844.10
| Professional | | $844.10 | $844.10 | $844.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.88 / $830.67 / $1,325.32
| Facility | | $642.88 | $830.67 | $1,325.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $659.56 / $879.57 / $1,364.69
| Professional | | $659.56 | $879.57 | $1,364.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $2,064.00 / $4,509.00
| Facility | | $600.00 | $2,064.00 | $4,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.72 / $679.18 / $1,085.21
| Professional | | $503.72 | $679.18 | $1,085.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.83 / $636.03 / $894.87
| Professional | | $564.83 | $636.03 | $894.87 |