- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.34 / $4,347.00 / $8,920.00
| Facility | | $689.34 | $4,347.00 | $8,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.11 / $594.82 / $983.21
| Professional | | $421.11 | $594.82 | $983.21 |
- 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
- $401.23 / $519.15 / $858.31
| Professional | | $401.23 | $519.15 | $858.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.34 / $512.46 / $3,714.00
| Professional | | $495.34 | $512.46 | $3,714.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $739.15
| Facility | | $640.00 | $640.00 | $739.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.91 / $639.20 / $1,169.45
| Professional | | $440.91 | $639.20 | $1,169.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.96 / $735.66 / $869.41
| Professional | | $572.96 | $735.66 | $869.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.31 / $675.36 / $1,048.22
| Facility | | $464.31 | $675.36 | $1,048.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $721.00 / $829.32 / $1,137.00
| Professional | | $721.00 | $829.32 | $1,137.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.27 / $554.13 / $1,888.74
| Facility | | $418.27 | $554.13 | $1,888.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.93 / $744.85 / $2,663.36
| Professional | | $506.93 | $744.85 | $2,663.36 |
- 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
- $438.03 / $669.47 / $1,153.46
| Professional | | $438.03 | $669.47 | $1,153.46 |