- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.22 / $2,756.27 / $8,294.00
| Facility | | $595.22 | $2,756.27 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.63 / $595.22 / $963.16
| Professional | | $485.63 | $595.22 | $963.16 |
- 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
- $503.31 / $671.29 / $942.99
| Professional | | $503.31 | $671.29 | $942.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.61 / $594.82 / $2,315.00
| Professional | | $548.61 | $594.82 | $2,315.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.61 / $891.61 / $891.61
| Facility | | $891.61 | $891.61 | $891.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.54 / $713.87 / $1,210.27
| Professional | | $518.54 | $713.87 | $1,210.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $670.63 / $744.18 / $885.93
| Professional | | $670.63 | $744.18 | $885.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.94 / $693.58 / $1,216.47
| Facility | | $505.94 | $693.58 | $1,216.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $796.00 / $902.00 / $1,260.00
| Professional | | $796.00 | $902.00 | $1,260.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.55 / $758.10 / $3,123.00
| Facility | | $526.55 | $758.10 | $3,123.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.80 / $880.15 / $3,123.00
| Professional | | $640.80 | $880.15 | $3,123.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,911.00 / $3,175.00 / $5,340.00
| Facility | | $1,911.00 | $3,175.00 | $5,340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.93 / $700.35 / $1,228.13
| Professional | | $453.93 | $700.35 | $1,228.13 |