- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.11 / $3,309.00 / $8,294.00
| Facility | | $823.11 | $3,309.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $659.66 / $817.31 / $893.08
| Professional | | $659.66 | $817.31 | $893.08 |
- 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
- $682.12 / $863.04 / $1,222.33
| Professional | | $682.12 | $863.04 | $1,222.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $711.98 / $711.98 / $11,515.00
| Professional | | $711.98 | $711.98 | $11,515.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,231.81 / $1,231.81 / $1,231.81
| Facility | | $1,231.81 | $1,231.81 | $1,231.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $685.79 / $855.07 / $1,588.02
| Professional | | $685.79 | $855.07 | $1,588.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $832.51 / $924.83 / $1,100.99
| Professional | | $832.51 | $924.83 | $1,100.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.41 / $860.37 / $1,185.09
| Facility | | $682.41 | $860.37 | $1,185.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $890.00 / $1,009.00 / $1,699.01
| Professional | | $890.00 | $1,009.00 | $1,699.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $648.52 / $908.58 / $7,030.19
| Facility | | $648.52 | $908.58 | $7,030.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $699.89 / $969.76 / $7,030.19
| Professional | | $699.89 | $969.76 | $7,030.19 |
- 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
- $554.45 / $832.23 / $1,436.12
| Professional | | $554.45 | $832.23 | $1,436.12 |