- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.32 / $1,758.00 / $8,017.00
| Facility | | $425.32 | $1,758.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.38 / $401.75 / $601.65
| Professional | | $294.38 | $401.75 | $601.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.52 / $471.67 / $711.47
| Professional | | $454.52 | $471.67 | $711.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.63 / $446.24 / $727.23
| Professional | | $311.63 | $446.24 | $727.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.96 / $705.81 / $728.06
| Professional | | $548.96 | $705.81 | $728.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,664.58 / $6,120.54 / $10,560.26
| Facility | | $5,664.58 | $6,120.54 | $10,560.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.40 / $355.40 / $355.40
| Professional | | $355.40 | $355.40 | $355.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $3,745.00 / $8,017.00
| Facility | | $657.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.50 / $425.33 / $1,263.23
| Professional | | $301.50 | $425.33 | $1,263.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.50 / $409.50 / $434.60
| Professional | | $409.50 | $409.50 | $434.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.58 / $577.58 / $577.58
| Facility | | $577.58 | $577.58 | $577.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.70 / $450.23 / $792.43
| Professional | | $316.70 | $450.23 | $792.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.32 / $333.15 / $447.28
| Facility | | $261.32 | $333.15 | $447.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.58 / $354.76 / $480.40
| Professional | | $325.58 | $354.76 | $480.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $2,391.00 / $6,000.00
| Facility | | $637.00 | $2,391.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.13 / $492.60 / $845.24
| Professional | | $379.13 | $492.60 | $845.24 |