- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $634.25 / $5,087.00 / $8,294.00
| Facility | | $634.25 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.11 / $602.94 / $933.59
| Professional | | $495.11 | $602.94 | $933.59 |
- 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
- $527.59 / $682.64 / $1,128.59
| Professional | | $527.59 | $682.64 | $1,128.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.08 / $653.70 / $3,714.00
| Professional | | $616.08 | $653.70 | $3,714.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $650.60
| Facility | | $640.00 | $640.00 | $650.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.11 / $744.29 / $1,237.47
| Professional | | $555.11 | $744.29 | $1,237.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.03 / $705.62 / $833.91
| Professional | | $550.03 | $705.62 | $833.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.27 / $742.07 / $1,077.74
| Facility | | $593.27 | $742.07 | $1,077.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $693.00 / $792.82 / $1,101.00
| Professional | | $693.00 | $792.82 | $1,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.70 / $718.03 / $1,683.00
| Facility | | $524.70 | $718.03 | $1,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.70 / $718.03 / $1,683.00
| Professional | | $524.70 | $718.03 | $1,683.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,629.00 / $2,819.00 / $5,790.00
| Facility | | $1,629.00 | $2,819.00 | $5,790.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.32 / $680.21 / $1,090.54
| Professional | | $435.32 | $680.21 | $1,090.54 |