- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.35 / $3,623.00 / $7,799.00
| Facility | | $525.35 | $3,623.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.76 / $496.76 / $694.75
| Professional | | $421.76 | $496.76 | $694.75 |
- 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
- $566.49 / $587.86 / $999.45
| Professional | | $566.49 | $587.86 | $999.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.59 / $574.92 / $1,020.29
| Professional | | $428.59 | $574.92 | $1,020.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.11 / $865.43 / $889.31
| Professional | | $673.11 | $865.43 | $889.31 |
- 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
- $441.28 / $524.23 / $3,051.69
| Professional | | $441.28 | $524.23 | $3,051.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.60 / $676.60 / $719.10
| Professional | | $676.60 | $676.60 | $719.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.90 / $852.90 / $852.90
| Facility | | $852.90 | $852.90 | $852.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.72 / $586.76 / $1,083.18
| Professional | | $454.72 | $586.76 | $1,083.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.54 / $497.23 / $558.88
| Facility | | $445.54 | $497.23 | $558.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.92 / $549.29 / $596.51
| Professional | | $487.92 | $549.29 | $596.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,113.00 / $4,789.00
| Facility | | $625.00 | $2,113.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.32 / $612.91 / $1,027.64
| Professional | | $473.32 | $612.91 | $1,027.64 |