- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.12 / $4,771.00 / $9,539.00
| Facility | | $524.12 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.01 / $524.12 / $606.24
| Professional | | $429.01 | $524.12 | $606.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,289.00 / $4,699.53 / $6,545.49
| Facility | | $3,289.00 | $4,699.53 | $6,545.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.17 / $561.60 / $770.23
| Professional | | $439.17 | $561.60 | $770.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.90 / $597.97 / $1,041.10
| Professional | | $533.90 | $597.97 | $1,041.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.20 / $603.55 / $1,153.06
| Professional | | $439.20 | $603.55 | $1,153.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.55 / $534.66 / $663.06
| Professional | | $445.55 | $534.66 | $663.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.16 / $610.23 / $885.76
| Facility | | $492.16 | $610.23 | $885.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.00 / $639.00 / $1,090.03
| Professional | | $527.00 | $639.00 | $1,090.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.68 / $604.45 / $1,989.47
| Facility | | $454.68 | $604.45 | $1,989.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.68 / $604.45 / $1,989.47
| Professional | | $454.68 | $604.45 | $1,989.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.46 / $538.24 / $990.29
| Professional | | $375.46 | $538.24 | $990.29 |