- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $2,747.00 / $8,017.00
| Facility | | $1,020.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $900.97 / $988.07 / $1,330.91
| Professional | | $900.97 | $988.07 | $1,330.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $959.68 / $995.90 / $1,772.09
| Professional | | $959.68 | $995.90 | $1,772.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $769.56 / $1,011.55 / $1,709.40
| Professional | | $769.56 | $1,011.55 | $1,709.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,157.52 / $1,157.52 / $1,492.65
| Professional | | $1,157.52 | $1,157.52 | $1,492.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $923.05 / $1,111.45 / $5,229.64
| Professional | | $923.05 | $1,111.45 | $5,229.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.80 / $977.80 / $1,248.90
| Professional | | $977.80 | $977.80 | $1,248.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $780.62 / $1,014.29 / $1,709.40
| Professional | | $780.62 | $1,014.29 | $1,709.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $876.60 / $945.41 / $945.41
| Facility | | $876.60 | $945.41 | $945.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $876.60 / $945.41 / $1,003.78
| Professional | | $876.60 | $945.41 | $1,003.78 |
- 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
- $823.90 / $1,112.51 / $1,884.68
| Professional | | $823.90 | $1,112.51 | $1,884.68 |