- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.61 / $5,087.00 / $8,294.00
| Facility | | $716.61 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $585.29 / $638.50 / $808.99
| Professional | | $585.29 | $638.50 | $808.99 |
- 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
- $567.32 / $725.48 / $1,199.43
| Professional | | $567.32 | $725.48 | $1,199.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $667.79 / $691.00 / $7,889.00
| Professional | | $667.79 | $691.00 | $7,889.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $690.84
| Facility | | $640.00 | $640.00 | $690.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.80 / $810.98 / $1,373.17
| Professional | | $598.80 | $810.98 | $1,373.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.20 / $747.78 / $876.59
| Professional | | $584.20 | $747.78 | $876.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.59 / $838.43 / $1,311.40
| Facility | | $635.59 | $838.43 | $1,311.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $761.00 / $886.00 / $1,264.00
| Professional | | $761.00 | $886.00 | $1,264.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.59 / $801.08 / $2,728.73
| Facility | | $590.59 | $801.08 | $2,728.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.59 / $801.08 / $2,728.73
| Professional | | $590.59 | $801.08 | $2,728.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,423.00 / $11,475.00 / $21,639.00
| Facility | | $6,423.00 | $11,475.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.61 / $760.89 / $1,163.50
| Professional | | $495.61 | $760.89 | $1,163.50 |