- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $977.24 / $13,182.57
| Facility | | $776.25 | $977.24 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $524.81 / $1,202.26
| Professional | | $389.05 | $524.81 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $831.76 / $1,174.90
| Professional | | $537.03 | $831.76 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $812.83 / $1,000.00
| Professional | | $363.08 | $812.83 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $758.58 / $17,378.01
| Facility | | $524.81 | $758.58 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $831.76 / $1,288.25
| Professional | | $588.84 | $831.76 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $758.58 / $794.33
| Facility | | $645.65 | $758.58 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $537.03 / $977.24
| Facility | | $457.09 | $537.03 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $741.31 / $1,096.48
| Professional | | $79.43 | $741.31 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,748.98 / $14,791.08
| Facility | | $8,317.64 | $11,748.98 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $933.25 / $1,258.93
| Professional | | $724.44 | $933.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $13,182.57 / $26,302.68
| Facility | | $2,137.96 | $13,182.57 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $812.83 / $1,148.15
| Professional | | $562.34 | $812.83 | $1,148.15 |