- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.51 / $5,048.00 / $10,637.11
| Facility | | $613.51 | $5,048.00 | $10,637.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.93 / $610.95 / $727.72
| Professional | | $491.93 | $610.95 | $727.72 |
- 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
- $452.07 / $578.10 / $955.77
| Professional | | $452.07 | $578.10 | $955.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.66 / $563.40 / $15,406.00
| Professional | | $521.66 | $563.40 | $15,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.83 / $559.83 / $900.00
| Facility | | $559.83 | $559.83 | $900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.83 / $683.47 / $1,117.97
| Professional | | $492.83 | $683.47 | $1,117.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.05 / $611.90 / $711.87
| Professional | | $478.05 | $611.90 | $711.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.48 / $717.81 / $1,122.72
| Facility | | $521.48 | $717.81 | $1,122.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.00 / $795.25 / $1,071.00
| Professional | | $678.00 | $795.25 | $1,071.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.15 / $687.63 / $2,221.34
| Facility | | $486.15 | $687.63 | $2,221.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.15 / $687.63 / $2,221.34
| Professional | | $486.15 | $687.63 | $2,221.34 |
- 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
- $410.69 / $618.59 / $978.78
| Professional | | $410.69 | $618.59 | $978.78 |