- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.07 / $5,412.00 / $11,024.00
| Facility | | $605.07 | $5,412.00 | $11,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.23 / $605.07 / $732.35
| Professional | | $457.23 | $605.07 | $732.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,671.00 / $14,495.61 / $20,189.45
| Facility | | $8,671.00 | $14,495.61 | $20,189.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.77 / $658.28 / $902.83
| Professional | | $514.77 | $658.28 | $902.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.14 / $783.36 / $1,222.05
| Professional | | $622.14 | $783.36 | $1,222.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.63 / $715.09 / $1,350.73
| Professional | | $527.63 | $715.09 | $1,350.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.35 / $637.62 / $786.40
| Professional | | $531.35 | $637.62 | $786.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.30 / $728.59 / $989.64
| Facility | | $514.30 | $728.59 | $989.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.00 / $757.00 / $1,288.00
| Professional | | $657.00 | $757.00 | $1,288.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.85 / $672.04 / $2,617.58
| Facility | | $437.85 | $672.04 | $2,617.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.22 / $690.86 / $5,122.00
| Professional | | $478.22 | $690.86 | $5,122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,373.00 / $17,192.00
| Facility | | $6,303.00 | $9,373.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.36 / $675.96 / $1,186.26
| Professional | | $448.36 | $675.96 | $1,186.26 |