- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.41 / $1,068.11 / $9,030.40
| Facility | | $391.41 | $1,068.11 | $9,030.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.00 / $507.00 / $2,016.96
| Professional | | $387.00 | $507.00 | $2,016.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,060.00 / $7,344.00 / $10,517.23
| Facility | | $5,060.00 | $7,344.00 | $10,517.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.55 / $1,255.20 / $2,921.81
| Professional | | $532.55 | $1,255.20 | $2,921.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,370.60 / $1,601.66 / $2,583.42
| Facility | | $1,370.60 | $1,601.66 | $2,583.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $772.59 / $1,269.41 / $1,935.92
| Professional | | $772.59 | $1,269.41 | $1,935.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.41 / $540.60 / $1,020.65
| Facility | | $391.41 | $540.60 | $1,020.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.54 / $828.99 / $8,384.00
| Facility | | $412.54 | $828.99 | $8,384.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $594.12 / $1,445.86 / $3,301.00
| Professional | | $594.12 | $1,445.86 | $3,301.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.30 / $435.86 / $1,149.41
| Professional | | $63.30 | $435.86 | $1,149.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.41 / $558.52 / $1,055.01
| Facility | | $391.41 | $558.52 | $1,055.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $936.84 / $1,295.60 / $1,876.31
| Professional | | $936.84 | $1,295.60 | $1,876.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,412.57 / $3,412.57 / $3,412.57
| Facility | | $3,412.57 | $3,412.57 | $3,412.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $790.04 / $2,203.19 / $3,896.24
| Professional | | $790.04 | $2,203.19 | $3,896.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,838.85 / $2,269.16 / $2,870.01
| Professional | | $1,838.85 | $2,269.16 | $2,870.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,614.00 / $6,477.00 / $8,384.00
| Facility | | $4,614.00 | $6,477.00 | $8,384.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.78 / $1,327.92 / $2,196.86
| Professional | | $567.78 | $1,327.92 | $2,196.86 |