- 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
- $552.03 / $668.19 / $1,064.00
| Professional | | $552.03 | $668.19 | $1,064.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,328.28 / $2,263.50 / $4,716.76
| Facility | | $1,328.28 | $2,263.50 | $4,716.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.98 / $773.36 / $1,053.83
| Professional | | $610.98 | $773.36 | $1,053.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $607.70 / $616.50
| Facility | | $80.00 | $607.70 | $616.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $753.64 / $753.64 / $753.64
| Facility | | $753.64 | $753.64 | $753.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $650.38 / $864.33 / $1,287.30
| Professional | | $650.38 | $864.33 | $1,287.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,110.25 / $11,500.00 / $26,542.00
| Facility | | $3,110.25 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,807.28 / $4,895.60 / $5,730.38
| Professional | | $4,807.28 | $4,895.60 | $5,730.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.20 / $754.10 / $1,196.58
| Facility | | $613.20 | $754.10 | $1,196.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $819.18 / $983.01 / $1,218.93
| Professional | | $819.18 | $983.01 | $1,218.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $820.10 / $820.10 / $820.10
| Professional | | $820.10 | $820.10 | $820.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.91 / $760.88 / $1,255.03
| Facility | | $618.91 | $760.88 | $1,255.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $659.91 / $888.89 / $1,344.94
| Professional | | $659.91 | $888.89 | $1,344.94 |
- 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
- $511.30 / $697.38 / $1,084.35
| Professional | | $511.30 | $697.38 | $1,084.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.30 / $634.07 / $882.31
| Professional | | $559.30 | $634.07 | $882.31 |