- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.73 / $1,181.00 / $7,439.00
| Facility | | $512.73 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.73 / $539.90 / $960.34
| Professional | | $512.73 | $539.90 | $960.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,457.61 / $1,457.61 / $1,478.88
| Facility | | $1,457.61 | $1,457.61 | $1,478.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.74 / $805.55 / $1,363.77
| Professional | | $315.74 | $805.55 | $1,363.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,587.44
| Facility | | $606.10 | $606.10 | $1,587.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.23 / $713.32 / $1,283.72
| Professional | | $526.23 | $713.32 | $1,283.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.73 / $652.52 / $921.08
| Facility | | $512.73 | $652.52 | $921.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $619.00 / $686.00
| Professional | | $507.00 | $619.00 | $686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $700.80 / $1,348.10
| Professional | | $4.00 | $700.80 | $1,348.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.06 / $614.60 / $1,254.08
| Professional | | $431.06 | $614.60 | $1,254.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,479.05 / $5,246.20 / $16,394.00
| Facility | | $2,479.05 | $5,246.20 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,480.39 / $4,480.39 / $4,571.93
| Professional | | $4,480.39 | $4,480.39 | $4,571.93 |