- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.59 / $1,071.52 / $1,628.13
| Facility | | $934.59 | $1,071.52 | $1,628.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $769.49 / $913.49 / $1,115.83
| Professional | | $769.49 | $913.49 | $1,115.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $858.43 / $977.70 / $977.70
| Professional | | $858.43 | $977.70 | $977.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.44 / $995.05 / $1,206.55
| Facility | | $569.44 | $995.05 | $1,206.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.22 / $1,066.44 / $2,024.92
| Professional | | $631.22 | $1,066.44 | $2,024.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $887.61 / $1,308.78 / $1,668.19
| Professional | | $887.61 | $1,308.78 | $1,668.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.05 / $2,533.27 / $4,939.47
| Facility | | $1,426.05 | $2,533.27 | $4,939.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.59 / $1,073.47 / $2,066.38
| Facility | | $934.59 | $1,073.47 | $2,066.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $788.41 / $915.02 / $1,192.01
| Professional | | $788.41 | $915.02 | $1,192.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,038.50 / $1,515.44 / $2,553.75
| Professional | | $1,038.50 | $1,515.44 | $2,553.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.45 / $995.05 / $1,005.46
| Facility | | $510.45 | $995.05 | $1,005.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.22 / $1,046.50 / $2,755.52
| Professional | | $631.22 | $1,046.50 | $2,755.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.46 / $1,036.46 / $1,100.00
| Facility | | $1,036.46 | $1,036.46 | $1,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.04 / $1,036.46 / $1,057.19
| Professional | | $615.04 | $1,036.46 | $1,057.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $771.61 / $1,100.00 / $1,872.69
| Professional | | $771.61 | $1,100.00 | $1,872.69 |