- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,745.00 / $8,427.00
| Facility | | $954.00 | $3,745.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.81 / $532.76 / $794.36
| Professional | | $477.81 | $532.76 | $794.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.70 / $567.05 / $964.51
| Professional | | $536.70 | $567.05 | $964.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.20 / $608.20 / $608.20
| Facility | | $608.20 | $608.20 | $608.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.41 / $643.03 / $1,076.16
| Professional | | $497.41 | $643.03 | $1,076.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $636.88 / $862.15 / $1,100.06
| Professional | | $636.88 | $862.15 | $1,100.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,853.46 / $6,853.46 / $6,853.46
| Facility | | $6,853.46 | $6,853.46 | $6,853.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,264.00 / $10,203.00
| Facility | | $1,013.00 | $4,264.00 | $10,203.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.82 / $606.65 / $2,775.50
| Professional | | $485.82 | $606.65 | $2,775.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $651.50 / $651.50 / $1,091.59
| Professional | | $651.50 | $651.50 | $1,091.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.20 / $608.20 / $608.20
| Facility | | $608.20 | $608.20 | $608.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.41 / $658.22 / $1,082.53
| Professional | | $497.41 | $658.22 | $1,082.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.47 / $520.47 / $578.28
| Facility | | $520.47 | $520.47 | $578.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.31 / $522.15 / $578.28
| Professional | | $505.31 | $522.15 | $578.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.70 / $639.54 / $1,038.67
| Professional | | $487.70 | $639.54 | $1,038.67 |