- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.00 / $3,570.00 / $10,893.00
| Facility | | $945.00 | $3,570.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $976.81 / $1,104.25 / $1,653.01
| Professional | | $976.81 | $1,104.25 | $1,653.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $972.34 / $1,230.75 / $1,695.44
| Professional | | $972.34 | $1,230.75 | $1,695.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,009.24 / $1,009.24 / $1,042.92
| Facility | | $1,009.24 | $1,009.24 | $1,042.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,024.00 / $4,619.00
| Facility | | $900.00 | $2,024.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,025.39 / $1,409.71 / $2,183.71
| Professional | | $1,025.39 | $1,409.71 | $2,183.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,355.41
| Facility | | $55.00 | $55.00 | $8,355.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,486.96 / $7,661.92 / $9,116.78
| Professional | | $7,486.96 | $7,661.92 | $9,116.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.27 / $1,274.71 / $2,245.14
| Facility | | $1,014.27 | $1,274.71 | $2,245.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,188.11 / $1,580.72 / $1,859.67
| Professional | | $1,188.11 | $1,580.72 | $1,859.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,338.10 / $2,653.00
| Professional | | $6.00 | $1,338.10 | $2,653.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.27 / $1,307.61 / $2,414.96
| Facility | | $1,014.27 | $1,307.61 | $2,414.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,065.24 / $1,490.89 / $2,637.74
| Professional | | $1,065.24 | $1,490.89 | $2,637.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,970.00 / $8,583.00
| Facility | | $385.00 | $1,970.00 | $8,583.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $889.82 / $1,168.53 / $1,868.13
| Professional | | $889.82 | $1,168.53 | $1,868.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $881.76 / $1,025.03 / $1,382.87
| Professional | | $881.76 | $1,025.03 | $1,382.87 |