- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.02 / $2,747.00 / $8,017.00
| Facility | | $660.02 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.83 / $621.14 / $850.95
| Professional | | $535.83 | $621.14 | $850.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $699.07 / $725.45 / $1,266.86
| Professional | | $699.07 | $725.45 | $1,266.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.94 / $724.91 / $1,302.41
| Professional | | $567.94 | $724.91 | $1,302.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $849.50 / $1,092.22 / $1,136.26
| Professional | | $849.50 | $1,092.22 | $1,136.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.94 / $660.02 / $3,292.63
| Professional | | $559.94 | $660.02 | $3,292.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.92 / $1,084.92 / $1,084.92
| Facility | | $1,084.92 | $1,084.92 | $1,084.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $594.48 / $743.19 / $1,308.26
| Professional | | $594.48 | $743.19 | $1,308.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.51 / $623.99 / $688.80
| Facility | | $604.51 | $623.99 | $688.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.51 / $660.27 / $731.62
| Professional | | $604.51 | $660.27 | $731.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $1,734.00 / $4,300.00
| Facility | | $637.00 | $1,734.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.25 / $780.68 / $1,329.07
| Professional | | $603.25 | $780.68 | $1,329.07 |