- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.43 / $970.05 / $4,285.39
| Facility | | $890.43 | $970.05 | $4,285.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $791.16 / $934.59 / $1,115.83
| Professional | | $791.16 | $934.59 | $1,115.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.10 / $1,849.52 / $3,207.88
| Facility | | $941.10 | $1,849.52 | $3,207.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.98 / $1,355.58 / $5,462.08
| Professional | | $776.98 | $1,355.58 | $5,462.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.17 / $857.91 / $1,074.51
| Facility | | $705.17 | $857.91 | $1,074.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $772.18 / $928.60 / $1,274.09
| Facility | | $772.18 | $928.60 | $1,274.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $970.99 / $1,637.06 / $2,825.85
| Professional | | $970.99 | $1,637.06 | $2,825.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.08 / $1,452.41 / $8,090.00
| Facility | | $854.08 | $1,452.41 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.37 / $944.06 / $1,546.31
| Professional | | $526.37 | $944.06 | $1,546.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,093.22 / $2,063.02 / $2,722.77
| Professional | | $1,093.22 | $2,063.02 | $2,722.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,849.52 / $1,849.52 / $4,622.51
| Facility | | $1,849.52 | $1,849.52 | $4,622.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.01 / $1,258.75 / $5,462.08
| Professional | | $565.01 | $1,258.75 | $5,462.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.89 / $1,209.75 / $2,429.57
| Professional | | $509.89 | $1,209.75 | $2,429.57 |