- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.73 / $4,771.00 / $9,539.00
| Facility | | $670.73 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.63 / $670.73 / $768.31
| Professional | | $521.63 | $670.73 | $768.31 |
- 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
- $575.00 / $735.30 / $1,008.46
| Professional | | $575.00 | $735.30 | $1,008.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $694.64 / $974.92 / $5,036.00
| Professional | | $694.64 | $974.92 | $5,036.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $592.88 / $797.50 / $1,525.76
| Professional | | $592.88 | $797.50 | $1,525.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $587.35 / $704.82 / $869.28
| Professional | | $587.35 | $704.82 | $869.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.01 / $811.05 / $1,133.53
| Facility | | $580.01 | $811.05 | $1,133.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $744.00 / $843.00 / $1,448.00
| Professional | | $744.00 | $843.00 | $1,448.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.85 / $797.56 / $5,122.00
| Facility | | $611.85 | $797.56 | $5,122.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.85 / $797.56 / $5,122.00
| Professional | | $611.85 | $797.56 | $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
- $500.16 / $776.58 / $1,345.47
| Professional | | $500.16 | $776.58 | $1,345.47 |