- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.74 / $2,747.00 / $8,017.00
| Facility | | $471.74 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.81 / $422.92 / $608.58
| Professional | | $276.81 | $422.92 | $608.58 |
- 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
- $488.41 / $506.84 / $506.84
| Professional | | $488.41 | $506.84 | $506.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.56 / $460.76 / $755.88
| Professional | | $304.56 | $460.76 | $755.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.77 / $769.85 / $798.75
| Professional | | $598.77 | $769.85 | $798.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,077.00 / $8,017.00
| Facility | | $832.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.02 / $443.78 / $1,544.00
| Professional | | $277.02 | $443.78 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.80 / $415.80 / $438.70
| Professional | | $415.80 | $415.80 | $438.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.02 / $537.02 / $537.02
| Facility | | $537.02 | $537.02 | $537.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.10 / $475.40 / $784.02
| Professional | | $314.10 | $475.40 | $784.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.69 / $308.82 / $483.97
| Facility | | $307.69 | $308.82 | $483.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.69 / $460.70 / $520.55
| Professional | | $307.69 | $460.70 | $520.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $4,300.00
| Facility | | $435.00 | $1,305.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.47 / $510.93 / $863.46
| Professional | | $400.47 | $510.93 | $863.46 |