- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.45 / $2,747.00 / $8,247.00
| Facility | | $530.45 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.45 / $512.38 / $788.52
| Professional | | $447.45 | $512.38 | $788.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.44 / $538.00 / $938.41
| Professional | | $518.44 | $538.00 | $938.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.41 / $586.41 / $586.41
| Facility | | $586.41 | $586.41 | $586.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.52 / $643.98 / $1,040.49
| Professional | | $474.52 | $643.98 | $1,040.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.62 / $841.28 / $1,059.90
| Professional | | $613.62 | $841.28 | $1,059.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,427.00
| Facility | | $832.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.45 / $554.33 / $2,655.14
| Professional | | $447.45 | $554.33 | $2,655.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.90 / $603.90 / $1,150.30
| Professional | | $603.90 | $603.90 | $1,150.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.41 / $586.41 / $586.41
| Facility | | $586.41 | $586.41 | $586.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.58 / $655.86 / $1,052.92
| Professional | | $477.58 | $655.86 | $1,052.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.48 / $505.48 / $525.04
| Facility | | $505.48 | $505.48 | $525.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.58 / $511.35 / $535.01
| Professional | | $486.58 | $511.35 | $535.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.59 / $651.95 / $1,025.72
| Professional | | $495.59 | $651.95 | $1,025.72 |