- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.00 / $5,087.00 / $8,294.00
| Facility | | $1,244.00 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $815.51 / $1,051.84 / $1,361.33
| Professional | | $815.51 | $1,051.84 | $1,361.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $951.54 / $1,222.20 / $1,727.21
| Professional | | $951.54 | $1,222.20 | $1,727.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,039.67 / $2,027.36 / $8,031.00
| Professional | | $1,039.67 | $2,027.36 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,179.98 / $1,179.98 / $1,179.98
| Facility | | $1,179.98 | $1,179.98 | $1,179.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.56 / $1,187.82 / $1,901.87
| Professional | | $891.56 | $1,187.82 | $1,901.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $983.32 / $1,156.84 / $1,482.50
| Professional | | $983.32 | $1,156.84 | $1,482.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.06 / $1,171.58 / $1,878.64
| Facility | | $880.06 | $1,171.58 | $1,878.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,194.00 / $1,356.00 / $2,003.19
| Professional | | $1,194.00 | $1,356.00 | $2,003.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $864.96 / $1,229.41 / $9,210.00
| Facility | | $864.96 | $1,229.41 | $9,210.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $864.96 / $1,229.41 / $9,210.00
| Professional | | $864.96 | $1,229.41 | $9,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $8,168.84 / $17,187.00
| Facility | | $5,121.00 | $8,168.84 | $17,187.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $696.45 / $944.78 / $1,853.61
| Professional | | $696.45 | $944.78 | $1,853.61 |