- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,128.61
| Facility | | $1,778.28 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $549.54 / $1,445.44
| Professional | | $467.74 | $549.54 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,888.44 / $45,708.82
| Facility | | $1,202.26 | $5,888.44 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $4,786.30
| Professional | | $478.63 | $776.25 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $3,311.31 / $3,311.31
| Professional | | $691.83 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $6,456.54
| Facility | | $676.08 | $741.31 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $676.08 / $1,380.38
| Professional | | $389.05 | $676.08 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $977.24 / $7,079.46
| Facility | | $446.68 | $977.24 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $676.08 / $1,000.00
| Professional | | $467.74 | $676.08 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,011.87 / $13,182.57
| Facility | | $776.25 | $5,011.87 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $831.76 / $1,258.93
| Professional | | $467.74 | $831.76 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,888.44 / $45,708.82
| Facility | | $1,202.26 | $5,888.44 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $4,786.30
| Professional | | $478.63 | $776.25 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,370.32 / $13,182.57
| Facility | | $1,584.89 | $5,370.32 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $741.31 / $1,380.38
| Professional | | $478.63 | $741.31 | $1,380.38 |