- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.92 / $5,087.00 / $8,294.00
| Facility | | $683.92 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.49 / $650.15 / $862.82
| Professional | | $583.49 | $650.15 | $862.82 |
- 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
- $577.46 / $738.45 / $1,220.86
| Professional | | $577.46 | $738.45 | $1,220.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.29 / $678.29 / $5,113.00
| Professional | | $678.29 | $678.29 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $704.92
| Facility | | $640.00 | $640.00 | $704.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.03 / $878.67 / $1,345.10
| Professional | | $609.03 | $878.67 | $1,345.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.65 / $763.46 / $902.27
| Professional | | $595.65 | $763.46 | $902.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.11 / $815.07 / $1,251.57
| Facility | | $598.11 | $815.07 | $1,251.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $757.00 / $880.95 / $1,192.00
| Professional | | $757.00 | $880.95 | $1,192.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.79 / $824.33 / $2,672.90
| Facility | | $597.79 | $824.33 | $2,672.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.79 / $824.33 / $2,672.90
| Professional | | $597.79 | $824.33 | $2,672.90 |
- 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
- $504.73 / $813.87 / $1,223.79
| Professional | | $504.73 | $813.87 | $1,223.79 |