- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,006.84 / $5,091.00 / $9,539.00
| Facility | | $1,006.84 | $5,091.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.29 / $608.27 / $800.21
| Professional | | $488.29 | $608.27 | $800.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.63 / $689.72 / $1,140.31
| Professional | | $527.63 | $689.72 | $1,140.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.54 / $666.59 / $3,019.00
| Professional | | $645.54 | $666.59 | $3,019.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $659.16
| Facility | | $640.00 | $640.00 | $659.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.71 / $702.88 / $1,246.60
| Professional | | $559.71 | $702.88 | $1,246.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.29 / $715.90 / $846.07
| Professional | | $557.29 | $715.90 | $846.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.05 / $739.82 / $1,077.59
| Facility | | $572.05 | $739.82 | $1,077.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $617.00 / $795.02 / $1,164.50
| Professional | | $617.00 | $795.02 | $1,164.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.38 / $725.40 / $2,477.07
| Facility | | $558.38 | $725.40 | $2,477.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.38 / $725.40 / $2,477.07
| Professional | | $558.38 | $725.40 | $2,477.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,006.00 / $8,168.00 / $17,187.00
| Facility | | $5,006.00 | $8,168.00 | $17,187.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.54 / $692.91 / $1,079.39
| Professional | | $438.54 | $692.91 | $1,079.39 |