- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.48 / $3,645.00 / $8,294.00
| Facility | | $609.48 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.14 / $509.85 / $619.33
| Professional | | $463.14 | $509.85 | $619.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.53 / $581.25 / $797.18
| Professional | | $454.53 | $581.25 | $797.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.96 / $797.70 / $3,426.00
| Professional | | $553.96 | $797.70 | $3,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.67 / $604.47 / $1,142.72
| Professional | | $454.67 | $604.47 | $1,142.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.06 / $558.07 / $688.29
| Professional | | $465.06 | $558.07 | $688.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.85 / $625.73 / $922.69
| Facility | | $509.85 | $625.73 | $922.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.00 / $635.00 / $1,083.00
| Professional | | $556.00 | $635.00 | $1,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.92 / $606.27 / $2,039.00
| Facility | | $431.92 | $606.27 | $2,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.92 / $606.27 / $2,039.00
| Professional | | $431.92 | $606.27 | $2,039.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,911.00 / $3,276.00 / $5,340.00
| Facility | | $1,911.00 | $3,276.00 | $5,340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.08 / $607.82 / $1,010.22
| Professional | | $369.08 | $607.82 | $1,010.22 |