- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.67 / $2,039.23 / $8,451.00
| Facility | | $401.67 | $2,039.23 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.54 / $374.87 / $704.95
| Professional | | $245.54 | $374.87 | $704.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.95 / $442.02 / $442.02
| Professional | | $425.95 | $442.02 | $442.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.58 / $412.91 / $656.53
| Professional | | $271.58 | $412.91 | $656.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.40 / $665.23 / $688.69
| Professional | | $517.40 | $665.23 | $688.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,427.63 / $1,713.94 / $2,950.16
| Facility | | $1,427.63 | $1,713.94 | $2,950.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.40 / $2,381.00 / $8,017.00
| Facility | | $413.40 | $2,381.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.33 / $404.45 / $1,201.21
| Professional | | $248.33 | $404.45 | $1,201.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.50 / $400.50 / $422.70
| Professional | | $400.50 | $400.50 | $422.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.57 / $478.57 / $478.57
| Facility | | $478.57 | $478.57 | $478.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.31 / $421.93 / $680.97
| Professional | | $279.31 | $421.93 | $680.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.77 / $282.99 / $419.54
| Facility | | $273.77 | $282.99 | $419.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.77 / $409.73 / $449.64
| Professional | | $273.77 | $409.73 | $449.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.95 / $457.34 / $800.76
| Professional | | $361.95 | $457.34 | $800.76 |