- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,088.00 / $3,645.00 / $8,294.00
| Facility | | $1,088.00 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $606.79 / $672.97 / $882.91
| Professional | | $606.79 | $672.97 | $882.91 |
- 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
- $596.21 / $762.42 / $1,260.50
| Professional | | $596.21 | $762.42 | $1,260.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $686.60 / $741.53 / $4,039.00
| Professional | | $686.60 | $741.53 | $4,039.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $728.34
| Facility | | $572.00 | $572.00 | $728.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.14 / $915.02 / $1,381.66
| Professional | | $631.14 | $915.02 | $1,381.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.74 / $790.42 / $934.13
| Professional | | $615.74 | $790.42 | $934.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.52 / $842.35 / $1,288.32
| Facility | | $664.52 | $842.35 | $1,288.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $774.00 / $925.84 / $1,226.00
| Professional | | $774.00 | $925.84 | $1,226.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.36 / $855.04 / $2,689.01
| Facility | | $622.36 | $855.04 | $2,689.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.36 / $855.04 / $2,689.01
| Professional | | $622.36 | $855.04 | $2,689.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $9,270.00 / $17,192.00
| Facility | | $5,121.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.45 / $836.00 / $1,320.14
| Professional | | $518.45 | $836.00 | $1,320.14 |