- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.16 / $8,920.00 / $16,967.00
| Facility | | $650.16 | $8,920.00 | $16,967.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.35 / $650.16 / $1,105.27
| Professional | | $520.35 | $650.16 | $1,105.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,096.00 / $47,452.00 / $53,038.00
| Facility | | $40,096.00 | $47,452.00 | $53,038.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.20 / $589.74 / $821.98
| Professional | | $463.20 | $589.74 | $821.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.01 / $751.10 / $8,031.00
| Professional | | $537.01 | $751.10 | $8,031.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.56 / $685.87 / $1,189.32
| Professional | | $507.56 | $685.87 | $1,189.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.80 / $573.36 / $707.14
| Professional | | $477.80 | $573.36 | $707.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.60 / $725.10 / $1,081.20
| Facility | | $556.60 | $725.10 | $1,081.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $654.00 / $734.00 / $1,175.78
| Professional | | $654.00 | $734.00 | $1,175.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.29 / $696.02 / $20,487.00
| Facility | | $506.29 | $696.02 | $20,487.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.29 / $696.02 / $20,487.00
| Professional | | $506.29 | $696.02 | $20,487.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,091.00 / $25,331.00 / $64,572.00
| Facility | | $13,091.00 | $25,331.00 | $64,572.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.23 / $701.30 / $1,148.94
| Professional | | $463.23 | $701.30 | $1,148.94 |