- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.77 / $3,226.00 / $8,294.00
| Facility | | $573.77 | $3,226.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.67 / $564.44 / $1,025.35
| Professional | | $503.67 | $564.44 | $1,025.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.29 / $589.89 / $809.03
| Professional | | $461.29 | $589.89 | $809.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $554.64 / $798.48 / $3,774.00
| Professional | | $554.64 | $798.48 | $3,774.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.07 / $672.06 / $1,242.11
| Professional | | $503.07 | $672.06 | $1,242.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.61 / $573.13 / $706.86
| Professional | | $477.61 | $573.13 | $706.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.16 / $694.49 / $1,016.08
| Facility | | $560.16 | $694.49 | $1,016.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.00 / $710.16 / $1,172.76
| Professional | | $626.00 | $710.16 | $1,172.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $680.29 / $3,512.00
| Facility | | $530.04 | $680.29 | $3,512.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.04 / $680.29 / $3,512.00
| Professional | | $530.04 | $680.29 | $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
- $433.73 / $685.74 / $1,087.45
| Professional | | $433.73 | $685.74 | $1,087.45 |