- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,838.00 / $8,427.00
| Facility | | $954.00 | $3,838.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.56 / $544.24 / $790.83
| Professional | | $486.56 | $544.24 | $790.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,463.00 / $11,091.00
| Facility | | $4,150.00 | $7,463.00 | $11,091.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.16 / $568.84 / $973.51
| Professional | | $548.16 | $568.84 | $973.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.33 / $622.33 / $622.33
| Facility | | $622.33 | $622.33 | $622.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.33 / $644.69 / $1,098.28
| Professional | | $487.33 | $644.69 | $1,098.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $652.19 / $882.66 / $1,126.51
| Professional | | $652.19 | $882.66 | $1,126.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.35 / $506.35 / $574.39
| Professional | | $506.35 | $506.35 | $574.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,606.00 / $10,527.00
| Facility | | $1,013.00 | $4,606.00 | $10,527.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.78 / $639.36 / $2,823.71
| Professional | | $496.78 | $639.36 | $2,823.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.50 / $556.50 / $1,116.40
| Professional | | $556.50 | $556.50 | $1,116.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.33 / $622.33 / $622.33
| Facility | | $622.33 | $622.33 | $622.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.33 / $664.88 / $1,098.28
| Professional | | $487.33 | $664.88 | $1,098.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.60 / $531.00 / $531.00
| Facility | | $470.60 | $531.00 | $531.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.60 / $531.00 / $565.57
| Professional | | $470.60 | $531.00 | $565.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.26 / $660.00 / $1,063.23
| Professional | | $472.26 | $660.00 | $1,063.23 |