- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $4,264.00 / $8,240.00
| Facility | | $882.00 | $4,264.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.59 / $502.72 / $699.31
| Professional | | $431.59 | $502.72 | $699.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.12 / $691.18 / $923.46
| Professional | | $435.12 | $691.18 | $923.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.71 / $637.30 / $997.80
| Professional | | $475.71 | $637.30 | $997.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.61 / $763.03 / $767.56
| Professional | | $576.61 | $763.03 | $767.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,247.00
| Facility | | $1,013.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.35 / $552.99 / $2,597.21
| Professional | | $450.35 | $552.99 | $2,597.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $609.40 / $1,228.40
| Professional | | $4.00 | $609.40 | $1,228.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.13 / $643.49 / $1,007.94
| Professional | | $476.13 | $643.49 | $1,007.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.20 / $478.20 / $531.42
| Facility | | $478.20 | $478.20 | $531.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.35 / $479.87 / $531.42
| Professional | | $464.35 | $479.87 | $531.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.00 / $3,331.00 / $6,000.00
| Facility | | $1,447.00 | $3,331.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.01 / $608.08 / $987.38
| Professional | | $469.01 | $608.08 | $987.38 |