- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.32 / $5,087.00 / $8,294.00
| Facility | | $671.32 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.23 / $634.03 / $839.84
| Professional | | $541.23 | $634.03 | $839.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.14 / $719.58 / $1,189.68
| Professional | | $556.14 | $719.58 | $1,189.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.07 / $662.07 / $1,251.31
| Professional | | $662.07 | $662.07 | $1,251.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $687.42
| Facility | | $640.00 | $640.00 | $687.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.79 / $732.65 / $1,308.72
| Professional | | $581.79 | $732.65 | $1,308.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $580.90 / $744.85 / $880.28
| Professional | | $580.90 | $744.85 | $880.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.62 / $761.42 / $1,127.44
| Facility | | $570.62 | $761.42 | $1,127.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.00 / $822.00 / $1,161.00
| Professional | | $709.00 | $822.00 | $1,161.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.91 / $747.88 / $1,683.00
| Facility | | $577.91 | $747.88 | $1,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $577.91 / $747.88 / $1,683.00
| Professional | | $577.91 | $747.88 | $1,683.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,713.00 / $2,863.00 / $5,340.00
| Facility | | $1,713.00 | $2,863.00 | $5,340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.88 / $714.59 / $1,169.22
| Professional | | $459.88 | $714.59 | $1,169.22 |