- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.40 / $3,839.00 / $8,247.00
| Facility | | $556.40 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.34 / $570.00 / $768.31
| Professional | | $501.34 | $570.00 | $768.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.17 / $641.17 / $641.17
| Professional | | $525.17 | $641.17 | $641.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.89 / $787.91 / $1,252.58
| Professional | | $582.89 | $787.91 | $1,252.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.67 / $973.93 / $973.93
| Professional | | $732.67 | $973.93 | $973.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.63 / $611.67 / $1,634.88
| Professional | | $521.63 | $611.67 | $1,634.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $769.20 / $1,579.70
| Professional | | $3.00 | $769.20 | $1,579.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.36 / $788.47 / $1,263.69
| Professional | | $589.36 | $788.47 | $1,263.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.39 / $610.39 / $723.35
| Facility | | $610.39 | $610.39 | $723.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.99 / $614.16 / $723.35
| Professional | | $590.99 | $614.16 | $723.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $569.44 / $768.86 / $1,232.28
| Professional | | $569.44 | $768.86 | $1,232.28 |