- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.02 / $5,412.00 / $11,425.00
| Facility | | $660.02 | $5,412.00 | $11,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.29 / $660.02 / $722.27
| Professional | | $548.29 | $660.02 | $722.27 |
- 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
- $536.28 / $685.79 / $940.56
| Professional | | $536.28 | $685.79 | $940.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.19 / $924.78 / $9,211.00
| Professional | | $644.19 | $924.78 | $9,211.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.92 / $785.39 / $1,447.17
| Professional | | $590.92 | $785.39 | $1,447.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.28 / $667.54 / $823.29
| Professional | | $556.28 | $667.54 | $823.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.54 / $810.03 / $1,138.30
| Facility | | $632.54 | $810.03 | $1,138.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $733.00 / $826.00 / $1,363.87
| Professional | | $733.00 | $826.00 | $1,363.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.62 / $799.07 / $6,585.00
| Facility | | $586.62 | $799.07 | $6,585.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.62 / $799.07 / $6,585.00
| Professional | | $586.62 | $799.07 | $6,585.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.00 / $11,671.00 / $21,639.00
| Facility | | $6,693.00 | $11,671.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.73 / $794.18 / $1,279.35
| Professional | | $509.73 | $794.18 | $1,279.35 |