- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.11 / $3,964.00 / $8,451.00
| Facility | | $566.11 | $3,964.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.75 / $541.47 / $654.62
| Professional | | $505.75 | $541.47 | $654.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.94 / $487.67 / $487.67
| Professional | | $469.94 | $487.67 | $487.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.51 / $646.35 / $972.10
| Professional | | $465.51 | $646.35 | $972.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $720.68 / $720.68 / $757.54
| Professional | | $720.68 | $720.68 | $757.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $5,342.00 / $8,990.00
| Facility | | $832.00 | $5,342.00 | $8,990.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.29 / $569.27 / $2,400.66
| Professional | | $495.29 | $569.27 | $2,400.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $912.90 / $1,168.20
| Professional | | $10.00 | $912.90 | $1,168.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.85 / $657.74 / $1,002.96
| Professional | | $509.85 | $657.74 | $1,002.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.54 / $458.54 / $671.96
| Facility | | $458.54 | $458.54 | $671.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.58 / $466.81 / $671.96
| Professional | | $438.58 | $466.81 | $671.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,322.00
| Facility | | $656.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.47 / $613.54 / $952.89
| Professional | | $459.47 | $613.54 | $952.89 |