- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.39 / $503.23 / $681.42
| Professional | | $456.39 | $503.23 | $681.42 |
- 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
- $448.05 / $659.19 / $894.16
| Professional | | $448.05 | $659.19 | $894.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.09 / $634.10 / $994.97
| Professional | | $450.09 | $634.10 | $994.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.92 / $810.63 / $822.93
| Professional | | $610.92 | $810.63 | $822.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.40 / $537.60 / $2,467.00
| Professional | | $456.40 | $537.60 | $2,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $513.29 / $1,379.50
| Professional | | $5.00 | $513.29 | $1,379.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.70 / $636.51 / $1,064.00
| Professional | | $490.70 | $636.51 | $1,064.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.56 / $507.57 / $507.57
| Facility | | $467.56 | $507.57 | $507.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.56 / $507.57 / $543.01
| Professional | | $467.56 | $507.57 | $543.01 |
- 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
- $418.48 / $566.17 / $972.04
| Professional | | $418.48 | $566.17 | $972.04 |