- 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
- $1,079.01 / $1,213.05 / $1,795.62
| Professional | | $1,079.01 | $1,213.05 | $1,795.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,086.53 / $1,375.64 / $1,916.08
| Professional | | $1,086.53 | $1,375.64 | $1,916.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,086.58 / $1,086.58 / $1,125.69
| Facility | | $1,086.58 | $1,086.58 | $1,125.69 |
- 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
- $1,078.07 / $1,535.71 / $2,407.08
| Professional | | $1,078.07 | $1,535.71 | $2,407.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $10,656.56
| Facility | | $55.00 | $55.00 | $10,656.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,342.64 / $8,531.60 / $10,198.28
| Professional | | $8,342.64 | $8,531.60 | $10,198.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,097.47 / $1,354.73 / $2,496.00
| Facility | | $1,097.47 | $1,354.73 | $2,496.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,326.50 / $1,764.82 / $2,076.26
| Professional | | $1,326.50 | $1,764.82 | $2,076.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $1,267.00 / $2,983.30
| Professional | | $7.00 | $1,267.00 | $2,983.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.42 / $1,354.73 / $2,673.83
| Facility | | $1,108.42 | $1,354.73 | $2,673.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,127.81 / $1,629.90 / $2,944.01
| Professional | | $1,127.81 | $1,629.90 | $2,944.01 |
- 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
- $934.81 / $1,290.39 / $2,028.64
| Professional | | $934.81 | $1,290.39 | $2,028.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $984.46 / $1,144.07 / $1,543.78
| Professional | | $984.46 | $1,144.07 | $1,543.78 |