- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $685.83 / $9,222.04 / $16,326.55
| Facility | | $685.83 | $9,222.04 | $16,326.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.47 / $492.01 / $1,583.57
| Professional | | $378.47 | $492.01 | $1,583.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.62 / $777.44 / $1,025.66
| Professional | | $490.62 | $777.44 | $1,025.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.67 / $793.98 / $893.94
| Professional | | $559.67 | $793.98 | $893.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.65 / $742.80 / $989.47
| Facility | | $455.65 | $742.80 | $989.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.48 / $634.26 / $1,115.07
| Professional | | $534.48 | $634.26 | $1,115.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.61 / $681.80 / $704.78
| Facility | | $496.61 | $681.80 | $704.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.65 / $851.58 / $6,246.00
| Facility | | $455.65 | $851.58 | $6,246.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $618.90 / $814.97 / $1,025.66
| Professional | | $618.90 | $814.97 | $1,025.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,508.06 / $11,474.33 / $13,050.49
| Facility | | $8,508.06 | $11,474.33 | $13,050.49 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,762.09 / $17,211.50 / $19,575.74
| Facility | 50 | $12,762.09 | $17,211.50 | $19,575.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.32 / $855.78 / $1,094.10
| Professional | | $635.32 | $855.78 | $1,094.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $9,074.00 / $12,786.00
| Facility | | $1,981.00 | $9,074.00 | $12,786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.97 / $755.49 / $1,098.99
| Professional | | $531.97 | $755.49 | $1,098.99 |