- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,225.58 / $5,412.00 / $11,024.00
| Facility | | $1,225.58 | $5,412.00 | $11,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.11 / $624.94 / $824.66
| Professional | | $535.11 | $624.94 | $824.66 |
- 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
- $554.10 / $708.58 / $1,171.49
| Professional | | $554.10 | $708.58 | $1,171.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $641.80 / $678.53 / $5,113.00
| Professional | | $641.80 | $678.53 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.02 / $677.02 / $776.00
| Facility | | $677.02 | $677.02 | $776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.85 / $753.60 / $1,285.23
| Professional | | $582.85 | $753.60 | $1,285.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.20 / $734.33 / $867.84
| Professional | | $572.20 | $734.33 | $867.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.57 / $779.68 / $1,200.00
| Facility | | $618.57 | $779.68 | $1,200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.00 / $829.98 / $1,142.00
| Professional | | $728.00 | $829.98 | $1,142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.85 / $758.48 / $2,553.85
| Facility | | $573.85 | $758.48 | $2,553.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $573.85 / $758.48 / $2,553.85
| Professional | | $573.85 | $758.48 | $2,553.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,061.00 / $8,291.00 / $17,187.00
| Facility | | $5,061.00 | $8,291.00 | $17,187.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.14 / $743.86 / $1,132.76
| Professional | | $456.14 | $743.86 | $1,132.76 |