- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.72 / $3,633.00 / $8,294.00
| Facility | | $723.72 | $3,633.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $606.10 / $714.25 / $793.46
| Professional | | $606.10 | $714.25 | $793.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.67 / $764.17 / $1,077.45
| Professional | | $600.67 | $764.17 | $1,077.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.24 / $673.24 / $15,962.00
| Professional | | $673.24 | $673.24 | $15,962.00 |
- 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
- $605.42 / $785.43 / $1,401.60
| Professional | | $605.42 | $785.43 | $1,401.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.90 / $815.70 / $971.08
| Professional | | $730.90 | $815.70 | $971.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.29 / $776.01 / $1,125.16
| Facility | | $604.29 | $776.01 | $1,125.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $845.00 / $963.00 / $1,482.70
| Professional | | $845.00 | $963.00 | $1,482.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.75 / $827.11 / $5,502.98
| Facility | | $607.75 | $827.11 | $5,502.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $639.76 / $885.71 / $5,502.98
| Professional | | $639.76 | $885.71 | $5,502.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,629.00 / $2,819.00 / $5,764.00
| Facility | | $1,629.00 | $2,819.00 | $5,764.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.21 / $740.32 / $1,268.08
| Professional | | $560.21 | $740.32 | $1,268.08 |