- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.97 / $3,988.00 / $8,294.00
| Facility | | $666.97 | $3,988.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.76 / $553.00 / $931.80
| Professional | | $407.76 | $553.00 | $931.80 |
- 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
- $392.73 / $508.15 / $840.12
| Professional | | $392.73 | $508.15 | $840.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.24 / $504.62 / $3,714.00
| Professional | | $467.24 | $504.62 | $3,714.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $729.27
| Facility | | $640.00 | $640.00 | $729.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.81 / $630.79 / $1,150.55
| Professional | | $429.81 | $630.79 | $1,150.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.35 / $715.33 / $845.39
| Professional | | $558.35 | $715.33 | $845.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.45 / $666.97 / $1,028.51
| Facility | | $441.45 | $666.97 | $1,028.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.00 / $822.00 / $1,096.00
| Professional | | $708.00 | $822.00 | $1,096.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.05 / $544.24 / $1,846.94
| Facility | | $411.05 | $544.24 | $1,846.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.52 / $725.86 / $2,515.57
| Professional | | $502.52 | $725.86 | $2,515.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,651.00 / $6,870.00 / $12,739.00
| Facility | | $3,651.00 | $6,870.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.05 / $666.52 / $1,145.68
| Professional | | $440.05 | $666.52 | $1,145.68 |