- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.12 / $5,091.00 / $9,539.00
| Facility | | $1,015.12 | $5,091.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.42 / $516.02 / $683.67
| Professional | | $444.42 | $516.02 | $683.67 |
- 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
- $457.61 / $585.17 / $967.47
| Professional | | $457.61 | $585.17 | $967.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.67 / $560.75 / $4,117.00
| Professional | | $531.67 | $560.75 | $4,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.46 / $559.46 / $640.00
| Facility | | $559.46 | $559.46 | $640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.83 / $641.76 / $1,063.36
| Professional | | $478.83 | $641.76 | $1,063.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.95 / $607.27 / $717.68
| Professional | | $472.95 | $607.27 | $717.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.66 / $643.89 / $959.16
| Facility | | $508.66 | $643.89 | $959.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.00 / $686.00 / $946.00
| Professional | | $603.00 | $686.00 | $946.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.79 / $614.85 / $2,230.00
| Facility | | $473.79 | $614.85 | $2,230.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.79 / $614.85 / $2,230.00
| Professional | | $473.79 | $614.85 | $2,230.00 |
- 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
- $376.43 / $591.19 / $938.25
| Professional | | $376.43 | $591.19 | $938.25 |