- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.67 / $2,747.00 / $8,017.00
| Facility | | $540.67 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.06 / $445.37 / $624.94
| Professional | | $332.06 | $445.37 | $624.94 |
- 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
- $565.61 / $586.95 / $586.95
| Professional | | $565.61 | $586.95 | $586.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.48 / $533.59 / $883.82
| Professional | | $361.48 | $533.59 | $883.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $686.41 / $882.52 / $912.61
| Professional | | $686.41 | $882.52 | $912.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.06 / $505.06 / $2,025.37
| Professional | | $332.06 | $505.06 | $2,025.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.29 / $534.29 / $564.60
| Professional | | $534.29 | $534.29 | $564.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $648.47 / $648.47 / $648.47
| Facility | | $648.47 | $648.47 | $648.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.29 / $550.35 / $907.64
| Professional | | $368.29 | $550.35 | $907.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.33 / $373.81 / $563.19
| Facility | | $349.33 | $373.81 | $563.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.82 / $514.91 / $604.61
| Professional | | $362.82 | $514.91 | $604.61 |
- 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
- $463.26 / $593.64 / $1,058.76
| Professional | | $463.26 | $593.64 | $1,058.76 |