- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $779.28 / $5,412.00 / $11,024.00
| Facility | | $779.28 | $5,412.00 | $11,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $670.94 / $779.28 / $969.84
| Professional | | $670.94 | $779.28 | $969.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $632.16 / $808.40 / $1,108.72
| Professional | | $632.16 | $808.40 | $1,108.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.73 / $889.75 / $1,482.92
| Professional | | $758.73 | $889.75 | $1,482.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $692.74 / $920.97 / $1,709.05
| Professional | | $692.74 | $920.97 | $1,709.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $655.02 / $786.02 / $969.43
| Professional | | $655.02 | $786.02 | $969.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $769.91 / $954.97 / $1,402.44
| Facility | | $769.91 | $954.97 | $1,402.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.00 / $993.00 / $1,607.38
| Professional | | $891.00 | $993.00 | $1,607.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.92 / $911.19 / $3,512.00
| Facility | | $708.92 | $911.19 | $3,512.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.92 / $911.19 / $3,512.00
| Professional | | $708.92 | $911.19 | $3,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,349.00 / $7,061.00 / $12,739.00
| Facility | | $4,349.00 | $7,061.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.46 / $892.41 / $1,423.20
| Professional | | $601.46 | $892.41 | $1,423.20 |