- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.09 / $3,623.00 / $7,799.00
| Facility | | $472.09 | $3,623.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.82 / $389.61 / $611.95
| Professional | | $292.82 | $389.61 | $611.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.44 / $518.29 / $868.89
| Professional | | $499.44 | $518.29 | $868.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.11 / $467.42 / $785.96
| Professional | | $315.11 | $467.42 | $785.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.12 / $775.44 / $802.14
| Professional | | $603.12 | $775.44 | $802.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.88 / $443.38 / $2,069.29
| Professional | | $298.88 | $443.38 | $2,069.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.90 / $447.90 / $470.00
| Professional | | $447.90 | $447.90 | $470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.78 / $591.78 / $591.78
| Facility | | $591.78 | $591.78 | $591.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.52 / $483.28 / $804.51
| Professional | | $326.52 | $483.28 | $804.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.39 / $339.52 / $494.76
| Facility | | $327.39 | $339.52 | $494.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.35 / $386.57 / $528.61
| Professional | | $328.35 | $386.57 | $528.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $4,300.00
| Facility | | $144.00 | $650.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.02 / $530.29 / $945.80
| Professional | | $415.02 | $530.29 | $945.80 |