- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.72 / $5,087.00 / $8,294.00
| Facility | | $766.72 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.94 / $720.50 / $960.26
| Professional | | $615.94 | $720.50 | $960.26 |
- 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
- $639.23 / $817.44 / $1,351.47
| Professional | | $639.23 | $817.44 | $1,351.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $743.98 / $780.18 / $4,117.00
| Professional | | $743.98 | $780.18 | $4,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $781.17
| Facility | | $640.00 | $640.00 | $781.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $670.06 / $848.27 / $1,496.10
| Professional | | $670.06 | $848.27 | $1,496.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $659.73 / $844.51 / $998.06
| Professional | | $659.73 | $844.51 | $998.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $692.43 / $897.06 / $1,318.52
| Facility | | $692.43 | $897.06 | $1,318.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $842.00 / $958.19 / $1,319.00
| Professional | | $842.00 | $958.19 | $1,319.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.45 / $859.87 / $2,973.15
| Facility | | $661.45 | $859.87 | $2,973.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.45 / $859.87 / $2,973.15
| Professional | | $661.45 | $859.87 | $2,973.15 |
- 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
- $526.29 / $788.30 / $1,295.39
| Professional | | $526.29 | $788.30 | $1,295.39 |