- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.00 / $5,091.00 / $9,539.00
| Facility | | $1,244.00 | $5,091.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $688.41 / $794.93 / $1,351.38
| Professional | | $688.41 | $794.93 | $1,351.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,823.00 / $12,004.00 / $15,528.00
| Facility | | $9,823.00 | $12,004.00 | $15,528.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.84 / $903.90 / $1,494.41
| Professional | | $706.84 | $903.90 | $1,494.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $824.24 / $862.88 / $7,889.00
| Professional | | $824.24 | $862.88 | $7,889.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $863.75
| Facility | | $640.00 | $640.00 | $863.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.59 / $944.85 / $1,653.37
| Professional | | $741.59 | $944.85 | $1,653.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $729.46 / $933.99 / $1,103.80
| Professional | | $729.46 | $933.99 | $1,103.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $778.99 / $995.00 / $1,532.66
| Facility | | $778.99 | $995.00 | $1,532.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $931.00 / $1,058.00 / $1,467.00
| Professional | | $931.00 | $1,058.00 | $1,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.26 / $952.19 / $3,442.00
| Facility | | $731.26 | $952.19 | $3,442.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $731.26 / $952.19 / $3,442.00
| Professional | | $731.26 | $952.19 | $3,442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.00 / $13,296.00 / $26,537.00
| Facility | | $7,408.00 | $13,296.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.96 / $916.07 / $1,431.57
| Professional | | $572.96 | $916.07 | $1,431.57 |