- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.00 / $2,561.00 / $8,920.00
| Facility | | $530.00 | $2,561.00 | $8,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.50 / $530.00 / $575.78
| Professional | | $439.50 | $530.00 | $575.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.95 / $539.59 / $740.04
| Professional | | $421.95 | $539.59 | $740.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.05 / $727.11 / $7,369.00
| Professional | | $502.05 | $727.11 | $7,369.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.86 / $629.17 / $1,159.32
| Professional | | $468.86 | $629.17 | $1,159.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.67 / $524.00 / $646.27
| Professional | | $436.67 | $524.00 | $646.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.19 / $650.46 / $922.65
| Facility | | $492.19 | $650.46 | $922.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.00 / $675.00 / $1,071.83
| Professional | | $588.00 | $675.00 | $1,071.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.06 / $637.99 / $2,039.00
| Facility | | $466.06 | $637.99 | $2,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.06 / $637.99 / $2,039.00
| Professional | | $466.06 | $637.99 | $2,039.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,911.00 / $3,276.00 / $5,340.00
| Facility | | $1,911.00 | $3,276.00 | $5,340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.38 / $647.94 / $1,024.88
| Professional | | $404.38 | $647.94 | $1,024.88 |