- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.72 / $5,087.00 / $8,920.00
| Facility | | $608.72 | $5,087.00 | $8,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.63 / $608.72 / $739.09
| Professional | | $463.63 | $608.72 | $739.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.22 / $671.64 / $921.15
| Professional | | $525.22 | $671.64 | $921.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.41 / $823.88 / $9,211.00
| Professional | | $635.41 | $823.88 | $9,211.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.76 / $738.38 / $1,364.29
| Professional | | $539.76 | $738.38 | $1,364.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.69 / $642.83 / $792.82
| Professional | | $535.69 | $642.83 | $792.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.79 / $747.06 / $1,028.74
| Facility | | $527.79 | $747.06 | $1,028.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $663.00 / $761.00 / $1,301.00
| Professional | | $663.00 | $761.00 | $1,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.16 / $723.84 / $5,122.00
| Facility | | $556.16 | $723.84 | $5,122.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.16 / $723.84 / $5,122.00
| Professional | | $556.16 | $723.84 | $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
- $452.86 / $697.31 / $1,206.08
| Professional | | $452.86 | $697.31 | $1,206.08 |