- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.98 / $1,245.00 / $8,413.00
| Facility | | $530.98 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.98 / $559.54 / $1,031.40
| Professional | | $530.98 | $559.54 | $1,031.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.62 / $109.62 / $111.22
| Facility | | $109.62 | $109.62 | $111.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.83 / $830.49 / $1,379.53
| Professional | | $600.83 | $830.49 | $1,379.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $648.07
| Facility | | $606.10 | $606.10 | $648.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.25 / $752.55 / $1,354.34
| Professional | | $567.25 | $752.55 | $1,354.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.98 / $699.00 / $1,059.46
| Facility | | $530.98 | $699.00 | $1,059.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $672.00 / $708.00
| Professional | | $579.00 | $672.00 | $708.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $721.20 / $1,266.30
| Professional | | $5.00 | $721.20 | $1,266.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.00 / $2,417.00 / $4,102.00
| Facility | | $554.00 | $2,417.00 | $4,102.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.96 / $677.33 / $1,442.05
| Professional | | $452.96 | $677.33 | $1,442.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,074.76 / $3,776.52 / $26,542.00
| Facility | | $3,074.76 | $3,776.52 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,241.68 / $4,241.68 / $4,719.68
| Professional | | $4,241.68 | $4,241.68 | $4,719.68 |