- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $685.61 / $3,645.00 / $8,294.00
| Facility | | $685.61 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.73 / $673.68 / $837.39
| Professional | | $590.73 | $673.68 | $837.39 |
- 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
- $549.79 / $703.08 / $964.27
| Professional | | $549.79 | $703.08 | $964.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.05 / $953.55 / $2,413.00
| Professional | | $662.05 | $953.55 | $2,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.12 / $796.16 / $1,476.48
| Professional | | $603.12 | $796.16 | $1,476.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.29 / $684.36 / $844.04
| Professional | | $570.29 | $684.36 | $844.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.96 / $826.78 / $1,210.93
| Facility | | $649.96 | $826.78 | $1,210.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.00 / $882.00 / $1,398.31
| Professional | | $730.00 | $882.00 | $1,398.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.20 / $788.79 / $3,512.00
| Facility | | $588.20 | $788.79 | $3,512.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.20 / $788.79 / $3,512.00
| Professional | | $588.20 | $788.79 | $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
- $504.20 / $857.67 / $1,305.27
| Professional | | $504.20 | $857.67 | $1,305.27 |