- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.12 / $1,741.00 / $7,629.00
| Facility | | $416.12 | $1,741.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.35 / $498.50 / $912.25
| Professional | | $372.35 | $498.50 | $912.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.59 / $754.99 / $1,011.29
| Professional | | $524.59 | $754.99 | $1,011.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.08 / $680.08 / $680.08
| Facility | | $680.08 | $680.08 | $680.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.61 / $567.90 / $954.19
| Professional | | $411.61 | $567.90 | $954.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.74 / $842.65 / $1,082.54
| Professional | | $626.74 | $842.65 | $1,082.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.52 / $4,069.97 / $5,702.13
| Facility | | $3,185.52 | $4,069.97 | $5,702.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.16 / $2,371.00 / $8,017.00
| Facility | | $563.16 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.10 / $561.41 / $1,559.87
| Professional | | $378.10 | $561.41 | $1,559.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.45 / $1,183.70 / $1,353.00
| Professional | | $732.45 | $1,183.70 | $1,353.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.08 / $680.08 / $680.08
| Facility | | $680.08 | $680.08 | $680.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.61 / $584.91 / $972.81
| Professional | | $411.61 | $584.91 | $972.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.63 / $393.67 / $522.35
| Facility | | $381.63 | $393.67 | $522.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.45 / $478.68 / $559.29
| Professional | | $382.45 | $478.68 | $559.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,305.00 / $3,742.00
| Facility | | $471.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.76 / $649.87 / $999.58
| Professional | | $473.76 | $649.87 | $999.58 |