- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.73 / $3,484.00 / $8,294.00
| Facility | | $665.73 | $3,484.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.54 / $579.58 / $797.34
| Professional | | $353.54 | $579.58 | $797.34 |
- 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
- $329.45 / $421.30 / $696.53
| Professional | | $329.45 | $421.30 | $696.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.60 / $416.26 / $916.00
| Professional | | $382.60 | $416.26 | $916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $609.29
| Facility | | $572.00 | $572.00 | $609.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.41 / $668.81 / $1,254.95
| Professional | | $375.41 | $668.81 | $1,254.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.30 / $770.41 / $910.48
| Professional | | $595.30 | $770.41 | $910.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.13 / $675.56 / $1,102.80
| Facility | | $366.13 | $675.56 | $1,102.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.00 / $1,027.00 / $1,213.00
| Professional | | $831.00 | $1,027.00 | $1,213.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.00 / $470.42 / $1,779.49
| Facility | | $349.00 | $470.42 | $1,779.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.91 / $850.45 / $2,813.07
| Professional | | $584.91 | $850.45 | $2,813.07 |
- 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
- $523.95 / $825.87 / $1,499.46
| Professional | | $523.95 | $825.87 | $1,499.46 |