- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $831.76 / $1,174.90
| Professional | | $676.08 | $831.76 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,466.84 / $9,120.11
| Facility | | $2,630.27 | $4,466.84 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $758.58 / $1,047.13
| Professional | | $616.60 | $758.58 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $977.24 / $1,584.89
| Professional | | $707.95 | $977.24 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $7,943.28
| Facility | | $54.95 | $56.23 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,786.30 / $5,888.44 / $5,888.44
| Professional | | $4,786.30 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,148.15 / $5,128.61
| Facility | | $707.95 | $1,148.15 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $891.25 / $1,148.15
| Professional | | $676.08 | $891.25 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $537.03
| Professional | | $32.36 | $33.11 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $977.24 / $1,698.24
| Facility | | $707.95 | $977.24 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $977.24 / $1,548.82
| Professional | | $676.08 | $977.24 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $812.83 / $1,288.25
| Professional | | $616.60 | $812.83 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $676.08
| Professional | | $616.60 | $616.60 | $676.08 |