- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,092.70 / $5,360.00 / $9,347.59
| Facility | | $1,092.70 | $5,360.00 | $9,347.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.22 / $664.42 / $1,129.51
| Professional | | $553.22 | $664.42 | $1,129.51 |
- 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
- $581.45 / $752.99 / $1,244.91
| Professional | | $581.45 | $752.99 | $1,244.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.29 / $721.67 / $5,113.00
| Professional | | $691.29 | $721.67 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $721.65 / $721.65 / $776.00
| Facility | | $721.65 | $721.65 | $776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $612.54 / $795.88 / $1,369.02
| Professional | | $612.54 | $795.88 | $1,369.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.96 / $783.50 / $925.95
| Professional | | $611.96 | $783.50 | $925.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.38 / $824.84 / $1,194.64
| Facility | | $650.38 | $824.84 | $1,194.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $779.00 / $881.50 / $1,227.00
| Professional | | $779.00 | $881.50 | $1,227.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.96 / $788.19 / $2,937.42
| Facility | | $611.96 | $788.19 | $2,937.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.96 / $788.19 / $2,937.42
| Professional | | $611.96 | $788.19 | $2,937.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.00 / $13,296.00 / $26,537.00
| Facility | | $7,408.00 | $13,296.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.60 / $747.24 / $1,167.66
| Professional | | $481.60 | $747.24 | $1,167.66 |