- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.52 / $7,920.26 / $20,400.00
| Facility | | $826.52 | $7,920.26 | $20,400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.32 / $508.47 / $1,981.39
| Professional | | $347.32 | $508.47 | $1,981.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.16 / $785.62 / $1,086.63
| Professional | | $504.16 | $785.62 | $1,086.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.78 / $826.98 / $941.41
| Professional | | $578.78 | $826.98 | $941.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.63 / $728.43 / $1,093.21
| Facility | | $358.63 | $728.43 | $1,093.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.83 / $780.61 / $1,174.50
| Professional | | $590.83 | $780.61 | $1,174.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.57 / $705.06 / $769.76
| Facility | | $535.57 | $705.06 | $769.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.47 / $911.34 / $1,093.21
| Facility | | $508.47 | $911.34 | $1,093.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $666.81 / $878.48 / $1,168.02
| Professional | | $666.81 | $878.48 | $1,168.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,246.10 / $77,972.48 / $94,895.79
| Facility | | $62,246.10 | $77,972.48 | $94,895.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $697.44 / $906.65 / $1,208.61
| Professional | | $697.44 | $906.65 | $1,208.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,425.00 / $64,404.00 / $94,117.00
| Facility | | $7,425.00 | $64,404.00 | $94,117.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.67 / $867.16 / $1,195.23
| Professional | | $576.67 | $867.16 | $1,195.23 |