- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.39 / $4,390.00 / $8,294.00
| Facility | | $625.39 | $4,390.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.75 / $670.92 / $901.38
| Professional | | $586.75 | $670.92 | $901.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.35 / $609.15 / $835.44
| Professional | | $476.35 | $609.15 | $835.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.07 / $818.02 / $7,369.00
| Professional | | $558.07 | $818.02 | $7,369.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.07 / $794.39 / $1,390.27
| Professional | | $546.07 | $794.39 | $1,390.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.72 / $738.86 / $911.27
| Professional | | $615.72 | $738.86 | $911.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.08 / $816.62 / $1,222.89
| Facility | | $598.08 | $816.62 | $1,222.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.00 / $963.00 / $1,384.00
| Professional | | $831.00 | $963.00 | $1,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.21 / $683.27 / $6,585.00
| Facility | | $514.21 | $683.27 | $6,585.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.27 / $873.47 / $6,585.00
| Professional | | $619.27 | $873.47 | $6,585.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.00 / $11,671.00 / $21,639.00
| Facility | | $6,693.00 | $11,671.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $528.11 / $922.28 / $1,406.51
| Professional | | $528.11 | $922.28 | $1,406.51 |