- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.98 / $4,771.00 / $9,539.00
| Facility | | $843.98 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.88 / $843.98 / $980.30
| Professional | | $715.88 | $843.98 | $980.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,385.00 / $9,527.62 / $13,270.04
| Facility | | $6,385.00 | $9,527.62 | $13,270.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.77 / $905.08 / $1,241.31
| Professional | | $707.77 | $905.08 | $1,241.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.41 / $953.58 / $1,660.25
| Professional | | $851.41 | $953.58 | $1,660.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $705.49 / $984.50 / $1,871.01
| Professional | | $705.49 | $984.50 | $1,871.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $714.13 / $856.96 / $1,060.95
| Professional | | $714.13 | $856.96 | $1,060.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.57 / $987.69 / $1,426.33
| Facility | | $789.57 | $987.69 | $1,426.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $857.00 / $1,035.00 / $1,751.23
| Professional | | $857.00 | $1,035.00 | $1,751.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.30 / $975.19 / $2,070.00
| Facility | | $712.30 | $975.19 | $2,070.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $712.30 / $975.19 / $2,070.00
| Professional | | $712.30 | $975.19 | $2,070.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.00 / $3,295.00 / $5,790.00
| Facility | | $1,621.00 | $3,295.00 | $5,790.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.26 / $949.58 / $1,606.91
| Professional | | $609.26 | $949.58 | $1,606.91 |