- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,105.06 / $5,293.00 / $9,701.10
| Facility | | $1,105.06 | $5,293.00 | $9,701.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.78 / $560.52 / $744.87
| Professional | | $482.78 | $560.52 | $744.87 |
- 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
- $498.17 / $637.04 / $1,053.23
| Professional | | $498.17 | $637.04 | $1,053.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.74 / $609.79 / $6,433.00
| Professional | | $564.74 | $609.79 | $6,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.20 / $608.20 / $640.00
| Facility | | $608.20 | $608.20 | $640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $516.57 / $693.95 / $1,156.96
| Professional | | $516.57 | $693.95 | $1,156.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.09 / $659.41 / $779.30
| Professional | | $514.09 | $659.41 | $779.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.82 / $702.03 / $1,022.39
| Facility | | $553.82 | $702.03 | $1,022.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.00 / $745.00 / $1,004.00
| Professional | | $657.00 | $745.00 | $1,004.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.55 / $683.62 / $2,300.36
| Facility | | $515.55 | $683.62 | $2,300.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.55 / $683.62 / $2,300.36
| Professional | | $515.55 | $683.62 | $2,300.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $9,270.00 / $17,192.00
| Facility | | $5,121.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.55 / $643.08 / $1,019.16
| Professional | | $425.55 | $643.08 | $1,019.16 |