- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.66 / $5,293.00 / $14,112.00
| Facility | | $710.66 | $5,293.00 | $14,112.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.49 / $672.69 / $972.04
| Professional | | $560.49 | $672.69 | $972.04 |
- 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
- $591.37 / $765.17 / $1,265.05
| Professional | | $591.37 | $765.17 | $1,265.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $729.52 / $753.31 / $5,113.00
| Professional | | $729.52 | $753.31 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.81 / $732.81 / $1,700.00
| Facility | | $732.81 | $732.81 | $1,700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.44 / $786.99 / $1,396.03
| Professional | | $604.44 | $786.99 | $1,396.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $618.88 / $792.46 / $936.55
| Professional | | $618.88 | $792.46 | $936.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.63 / $828.51 / $1,174.93
| Facility | | $666.63 | $828.51 | $1,174.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $782.00 / $903.15 / $1,242.00
| Professional | | $782.00 | $903.15 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.61 / $799.04 / $2,774.18
| Facility | | $613.61 | $799.04 | $2,774.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.61 / $799.04 / $2,774.18
| Professional | | $613.61 | $799.04 | $2,774.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,061.00 / $8,168.00 / $17,187.00
| Facility | | $5,061.00 | $8,168.00 | $17,187.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.94 / $744.86 / $1,208.76
| Professional | | $475.94 | $744.86 | $1,208.76 |