- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $983.00 / $3,742.00 / $13,004.00
| Facility | | $983.00 | $3,742.00 | $13,004.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $939.22 / $1,084.14 / $1,372.76
| Professional | | $939.22 | $1,084.14 | $1,372.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,492.73 / $4,350.91 / $8,895.81
| Facility | | $2,492.73 | $4,350.91 | $8,895.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $880.92 / $1,115.04 / $1,553.49
| Professional | | $880.92 | $1,115.04 | $1,553.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $879.70 / $879.70 / $879.70
| Facility | | $879.70 | $879.70 | $879.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,006.68 / $1,325.20 / $2,212.80
| Professional | | $1,006.68 | $1,325.20 | $2,212.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $11,827.97
| Facility | | $55.00 | $55.00 | $11,827.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,091.00 / $7,091.00 / $8,261.48
| Professional | | $7,091.00 | $7,091.00 | $8,261.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,004.52 / $1,299.67 / $2,635.00
| Facility | | $1,004.52 | $1,299.67 | $2,635.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,214.83 / $1,401.74 / $1,682.08
| Professional | | $1,214.83 | $1,401.74 | $1,682.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $976.56 / $1,109.72 / $2,091.08
| Professional | | $976.56 | $1,109.72 | $2,091.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,004.52 / $1,312.80 / $2,665.88
| Facility | | $1,004.52 | $1,312.80 | $2,665.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,005.24 / $1,383.86 / $2,391.75
| Professional | | $1,005.24 | $1,383.86 | $2,391.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $839.16 / $1,119.46 / $1,766.00
| Professional | | $839.16 | $1,119.46 | $1,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $797.56 / $915.17 / $1,247.25
| Professional | | $797.56 | $915.17 | $1,247.25 |