- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.00 / $2,675.00 / $8,017.00
| Facility | | $1,058.00 | $2,675.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $903.44 / $1,065.53 / $1,640.03
| Professional | | $903.44 | $1,065.53 | $1,640.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,050.86 / $1,090.53 / $1,936.47
| Professional | | $1,050.86 | $1,090.53 | $1,936.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.38 / $1,189.38 / $1,189.38
| Facility | | $1,189.38 | $1,189.38 | $1,189.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $976.08 / $1,304.55 / $2,104.98
| Professional | | $976.08 | $1,304.55 | $2,104.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,237.56 / $1,679.46 / $2,137.60
| Professional | | $1,237.56 | $1,679.46 | $2,137.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $2,679.00 / $8,017.00
| Facility | | $1,013.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $934.00 / $1,177.33 / $2,843.00
| Professional | | $934.00 | $1,177.33 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,134.59 / $1,134.59 / $2,214.40
| Professional | | $1,134.59 | $1,134.59 | $2,214.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.38 / $1,189.38 / $1,189.38
| Facility | | $1,189.38 | $1,189.38 | $1,189.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $987.71 / $1,338.37 / $2,115.03
| Professional | | $987.71 | $1,338.37 | $2,115.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.23 / $1,026.23 / $1,069.67
| Facility | | $1,026.23 | $1,026.23 | $1,069.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $991.81 / $1,034.25 / $1,084.41
| Professional | | $991.81 | $1,034.25 | $1,084.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,056.36 / $1,310.38 / $1,980.95
| Professional | | $1,056.36 | $1,310.38 | $1,980.95 |