- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.74 / $2,747.00 / $7,263.00
| Facility | | $626.74 | $2,747.00 | $7,263.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.90 / $556.67 / $1,021.63
| Professional | | $400.90 | $556.67 | $1,021.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.41 / $610.62 / $610.62
| Professional | | $588.41 | $610.62 | $610.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.15 / $739.15 / $739.15
| Facility | | $739.15 | $739.15 | $739.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.21 / $602.16 / $1,061.76
| Professional | | $422.21 | $602.16 | $1,061.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $700.79 / $932.46 / $1,210.45
| Professional | | $700.79 | $932.46 | $1,210.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,523.93 / $6,853.46 / $9,262.60
| Facility | | $3,523.93 | $6,853.46 | $9,262.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.35 / $458.96 / $517.71
| Professional | | $441.35 | $458.96 | $517.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.00 / $3,623.00 / $7,799.00
| Facility | | $655.00 | $3,623.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.60 / $592.80 / $1,267.84
| Professional | | $404.60 | $592.80 | $1,267.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.10 / $555.10 / $1,307.40
| Professional | | $555.10 | $555.10 | $1,307.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.15 / $739.15 / $739.15
| Facility | | $739.15 | $739.15 | $739.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.31 / $615.29 / $1,082.30
| Professional | | $433.31 | $615.29 | $1,082.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.83 / $471.34 / $580.91
| Facility | | $422.83 | $471.34 | $580.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.81 / $505.29 / $621.66
| Professional | | $421.81 | $505.29 | $621.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.27 / $699.61 / $1,201.11
| Professional | | $507.27 | $699.61 | $1,201.11 |