- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.48 / $1,245.00 / $8,413.00
| Facility | | $636.48 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.46 / $636.48 / $1,186.84
| Professional | | $605.46 | $636.48 | $1,186.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.88 / $927.66 / $1,557.40
| Professional | | $533.88 | $927.66 | $1,557.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,438.74
| Facility | | $606.10 | $606.10 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.29 / $865.29 / $1,527.58
| Professional | | $657.29 | $865.29 | $1,527.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.48 / $790.62 / $1,242.51
| Facility | | $636.48 | $790.62 | $1,242.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $634.00 / $840.00
| Professional | | $579.00 | $634.00 | $840.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $859.30 / $1,524.10
| Professional | | $3.00 | $859.30 | $1,524.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.34 / $732.85 / $1,599.72
| Professional | | $514.34 | $732.85 | $1,599.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,426.16 / $4,754.80 / $26,542.00
| Facility | | $2,426.16 | $4,754.80 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,697.28 / $4,697.28 / $5,593.20
| Professional | | $4,697.28 | $4,697.28 | $5,593.20 |