- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.96 / $3,645.00 / $8,294.00
| Facility | | $550.96 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.05 / $550.96 / $601.57
| Professional | | $456.05 | $550.96 | $601.57 |
- 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
- $448.69 / $573.78 / $786.93
| Professional | | $448.69 | $573.78 | $786.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.03 / $777.66 / $7,369.00
| Professional | | $540.03 | $777.66 | $7,369.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.18 / $651.13 / $1,206.09
| Professional | | $491.18 | $651.13 | $1,206.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.21 / $558.25 / $688.51
| Professional | | $465.21 | $558.25 | $688.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $529.51 / $676.17 / $951.84
| Facility | | $529.51 | $676.17 | $951.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.00 / $680.00 / $1,140.96
| Professional | | $610.00 | $680.00 | $1,140.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.45 / $650.04 / $5,122.00
| Facility | | $479.45 | $650.04 | $5,122.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.45 / $650.04 / $5,122.00
| Professional | | $479.45 | $650.04 | $5,122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,373.00 / $17,192.00
| Facility | | $6,303.00 | $9,373.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.83 / $626.33 / $1,055.71
| Professional | | $417.83 | $626.33 | $1,055.71 |