- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.97 / $5,087.00 / $8,294.00
| Facility | | $636.97 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.79 / $604.27 / $788.92
| Professional | | $515.79 | $604.27 | $788.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.11 / $684.61 / $1,131.85
| Professional | | $529.11 | $684.61 | $1,131.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.04 / $629.04 / $5,113.00
| Professional | | $629.04 | $629.04 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $654.32
| Facility | | $640.00 | $640.00 | $654.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.46 / $746.80 / $1,242.00
| Professional | | $558.46 | $746.80 | $1,242.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.01 / $709.70 / $838.73
| Professional | | $553.01 | $709.70 | $838.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.58 / $729.43 / $1,070.74
| Facility | | $544.58 | $729.43 | $1,070.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.00 / $796.00 / $1,103.00
| Professional | | $644.00 | $796.00 | $1,103.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.11 / $713.90 / $2,467.91
| Facility | | $554.11 | $713.90 | $2,467.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $554.11 / $713.90 / $2,467.91
| Professional | | $554.11 | $713.90 | $2,467.91 |
- 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
- $440.75 / $644.16 / $1,059.57
| Professional | | $440.75 | $644.16 | $1,059.57 |