- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.42 / $4,761.00 / $8,451.00
| Facility | | $1,070.42 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $890.80 / $998.09 / $1,344.39
| Professional | | $890.80 | $998.09 | $1,344.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $962.20 / $998.51 / $1,730.64
| Professional | | $962.20 | $998.51 | $1,730.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $771.98 / $998.52 / $1,700.27
| Professional | | $771.98 | $998.52 | $1,700.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,160.06 / $1,160.06 / $1,495.93
| Professional | | $1,160.06 | $1,160.06 | $1,495.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,143.86 / $3,143.86 / $3,143.86
| Facility | | $3,143.86 | $3,143.86 | $3,143.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.42 / $5,342.00 / $9,617.00
| Facility | | $1,070.42 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $899.16 / $1,139.22 / $5,958.00
| Professional | | $899.16 | $1,139.22 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,008.30 / $1,008.30 / $1,008.30
| Professional | | $1,008.30 | $1,008.30 | $1,008.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $788.57 / $1,015.13 / $1,700.27
| Professional | | $788.57 | $1,015.13 | $1,700.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $857.95 / $952.32 / $952.32
| Facility | | $857.95 | $952.32 | $952.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $857.95 / $952.32 / $1,011.02
| Professional | | $857.95 | $952.32 | $1,011.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $822.45 / $1,083.01 / $1,844.08
| Professional | | $822.45 | $1,083.01 | $1,844.08 |