- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.71 / $3,623.00 / $8,017.00
| Facility | | $665.71 | $3,623.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.38 / $612.90 / $829.71
| Professional | | $486.38 | $612.90 | $829.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,800.00 / $11,479.00 / $17,952.00
| Facility | | $5,800.00 | $11,479.00 | $17,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.13 / $828.50 / $1,261.85
| Professional | | $557.13 | $828.50 | $1,261.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.48 / $729.44 / $1,182.83
| Professional | | $506.48 | $729.44 | $1,182.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $759.48 / $1,006.17 / $1,031.31
| Professional | | $759.48 | $1,006.17 | $1,031.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,495.40 / $12,495.40 / $15,291.45
| Facility | | $12,495.40 | $12,495.40 | $15,291.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.00 / $3,745.00 / $8,017.00
| Facility | | $749.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.12 / $657.13 / $2,053.21
| Professional | | $493.12 | $657.13 | $2,053.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $546.79 / $1,699.70
| Professional | | $5.00 | $546.79 | $1,699.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.11 / $750.29 / $1,247.77
| Professional | | $538.11 | $750.29 | $1,247.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.07 / $499.61 / $620.07
| Facility | | $425.07 | $499.61 | $620.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.27 / $560.07 / $664.83
| Professional | | $489.27 | $560.07 | $664.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $542.66 / $734.21 / $1,277.83
| Professional | | $542.66 | $734.21 | $1,277.83 |