- 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
- $943.40 / $1,213.25 / $1,564.14
| Professional | | $943.40 | $1,213.25 | $1,564.14 |
- 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
- $1,096.15 / $1,407.94 / $1,989.69
| Professional | | $1,096.15 | $1,407.94 | $1,989.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,180.25 / $2,301.48 / $9,638.00
| Professional | | $1,180.25 | $2,301.48 | $9,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,359.30 / $1,359.30 / $1,359.30
| Facility | | $1,359.30 | $1,359.30 | $1,359.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,001.53 / $1,336.93 / $2,211.46
| Professional | | $1,001.53 | $1,336.93 | $2,211.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,128.38 / $1,327.50 / $1,704.09
| Professional | | $1,128.38 | $1,327.50 | $1,704.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.19 / $1,368.56 / $2,149.25
| Facility | | $1,014.19 | $1,368.56 | $2,149.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,347.00 / $1,547.00 / $2,305.71
| Professional | | $1,347.00 | $1,547.00 | $2,305.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,009.64 / $1,417.72 / $9,210.00
| Facility | | $1,009.64 | $1,417.72 | $9,210.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,009.64 / $1,417.72 / $9,210.00
| Professional | | $1,009.64 | $1,417.72 | $9,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,270.00 / $17,192.00
| Facility | | $6,303.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $819.22 / $1,102.21 / $1,988.24
| Professional | | $819.22 | $1,102.21 | $1,988.24 |