- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.63 / $4,771.00 / $8,294.00
| Facility | | $352.63 | $4,771.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.17 / $410.20 / $643.76
| Professional | | $315.17 | $410.20 | $643.76 |
- 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
- $323.39 / $450.22 / $665.99
| Professional | | $323.39 | $450.22 | $665.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.15 / $461.62 / $4,284.00
| Professional | | $353.15 | $461.62 | $4,284.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.06 / $504.20 / $869.04
| Professional | | $330.06 | $504.20 | $869.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.74 / $515.69 / $636.61
| Professional | | $429.74 | $515.69 | $636.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.63 / $513.28 / $787.90
| Facility | | $352.63 | $513.28 | $787.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.00 / $622.00 / $927.00
| Professional | | $529.00 | $622.00 | $927.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.49 / $410.39 / $3,512.00
| Facility | | $297.49 | $410.39 | $3,512.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.55 / $588.47 / $3,512.00
| Professional | | $436.55 | $588.47 | $3,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,349.00 / $7,061.00 / $12,739.00
| Facility | | $4,349.00 | $7,061.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.83 / $593.44 / $1,002.33
| Professional | | $352.83 | $593.44 | $1,002.33 |