- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.50 / $3,309.00 / $8,294.00
| Facility | | $564.50 | $3,309.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.27 / $546.79 / $701.29
| Professional | | $445.27 | $546.79 | $701.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.75 / $507.36 / $838.81
| Professional | | $396.75 | $507.36 | $838.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.95 / $556.45 / $6,433.00
| Professional | | $484.95 | $556.45 | $6,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $737.77
| Facility | | $572.00 | $572.00 | $737.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.79 / $652.30 / $1,127.84
| Professional | | $456.79 | $652.30 | $1,127.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.21 / $674.88 / $797.59
| Professional | | $526.21 | $674.88 | $797.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.22 / $695.75 / $1,087.19
| Facility | | $494.22 | $695.75 | $1,087.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $720.00 / $848.00 / $1,041.00
| Professional | | $720.00 | $848.00 | $1,041.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.79 / $604.10 / $1,968.45
| Facility | | $426.79 | $604.10 | $1,968.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.29 / $733.78 / $2,438.36
| Professional | | $518.29 | $733.78 | $2,438.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,651.00 / $6,870.00 / $12,739.00
| Facility | | $3,651.00 | $6,870.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.42 / $681.09 / $1,092.86
| Professional | | $431.42 | $681.09 | $1,092.86 |