- 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
- $499.34 / $539.04 / $721.02
| Professional | | $499.34 | $539.04 | $721.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.17 / $796.82 / $1,059.70
| Professional | | $502.17 | $796.82 | $1,059.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.60 / $735.04 / $1,146.34
| Professional | | $548.60 | $735.04 | $1,146.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.21 / $880.11 / $885.98
| Professional | | $665.21 | $880.11 | $885.98 |
- 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
- $520.91 / $584.33 / $2,994.82
| Professional | | $520.91 | $584.33 | $2,994.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $699.40 / $1,421.30
| Professional | | $3.00 | $699.40 | $1,421.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.23 / $743.63 / $1,146.40
| Professional | | $550.23 | $743.63 | $1,146.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.45 / $552.45 / $663.67
| Facility | | $552.45 | $552.45 | $663.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.48 / $554.33 / $663.67
| Professional | | $536.48 | $554.33 | $663.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.00 / $4,300.00 / $11,100.87
| Facility | | $1,781.00 | $4,300.00 | $11,100.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $516.51 / $698.03 / $1,200.14
| Professional | | $516.51 | $698.03 | $1,200.14 |