- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.26 / $3,991.00 / $8,920.00
| Facility | | $558.26 | $3,991.00 | $8,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.94 / $558.26 / $607.14
| Professional | | $462.94 | $558.26 | $607.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.69 / $568.66 / $779.93
| Professional | | $444.69 | $568.66 | $779.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.04 / $717.85 / $2,315.00
| Professional | | $529.04 | $717.85 | $2,315.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.70 / $662.57 / $1,221.39
| Professional | | $486.70 | $662.57 | $1,221.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.82 / $551.78 / $680.53
| Professional | | $459.82 | $551.78 | $680.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.11 / $685.14 / $971.08
| Facility | | $518.11 | $685.14 | $971.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.00 / $711.00 / $1,129.63
| Professional | | $622.00 | $711.00 | $1,129.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.79 / $663.83 / $1,632.00
| Facility | | $490.79 | $663.83 | $1,632.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.79 / $663.83 / $1,632.00
| Professional | | $490.79 | $663.83 | $1,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,066.00 / $1,893.00 / $3,765.00
| Facility | | $1,066.00 | $1,893.00 | $3,765.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.92 / $693.63 / $1,026.23
| Professional | | $425.92 | $693.63 | $1,026.23 |