- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.31 / $3,570.00 / $10,893.00
| Facility | | $756.31 | $3,570.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.12 / $715.25 / $1,062.40
| Professional | | $630.12 | $715.25 | $1,062.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.15 / $1,383.21 / $13,457.45
| Facility | | $557.15 | $1,383.21 | $13,457.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $641.46 / $811.93 / $1,131.20
| Professional | | $641.46 | $811.93 | $1,131.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.54 / $645.54 / $667.02
| Facility | | $645.54 | $645.54 | $667.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.88 / $2,024.00 / $4,619.00
| Facility | | $791.88 | $2,024.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.10 / $908.00 / $1,400.31
| Professional | | $678.10 | $908.00 | $1,400.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $6,316.72
| Facility | | $55.00 | $55.00 | $6,316.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,818.02 / $10,112.56 / $10,112.56
| Professional | | $9,818.02 | $10,112.56 | $10,112.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.22 / $829.04 / $1,484.07
| Facility | | $664.22 | $829.04 | $1,484.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $785.63 / $1,045.23 / $1,229.69
| Professional | | $785.63 | $1,045.23 | $1,229.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $664.89 / $870.72 / $1,451.20
| Professional | | $664.89 | $870.72 | $1,451.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.22 / $840.89 / $1,563.31
| Facility | | $664.22 | $840.89 | $1,563.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $701.36 / $961.29 / $1,709.33
| Professional | | $701.36 | $961.29 | $1,709.33 |
- 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
- $558.83 / $756.44 / $1,220.16
| Professional | | $558.83 | $756.44 | $1,220.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.05 / $677.75 / $914.84
| Professional | | $583.05 | $677.75 | $914.84 |