- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,747.00 / $8,017.00
| Facility | | $540.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.38 / $435.38 / $634.79
| Professional | | $337.38 | $435.38 | $634.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,463.00 / $11,091.00
| Facility | | $4,150.00 | $7,463.00 | $11,091.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.87 / $475.15 / $475.15
| Professional | | $457.87 | $475.15 | $475.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.32 / $614.32 / $614.32
| Facility | | $614.32 | $614.32 | $614.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.35 / $528.32 / $899.90
| Professional | | $367.35 | $528.32 | $899.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.15 / $723.39 / $939.89
| Professional | | $544.15 | $723.39 | $939.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,850.20 / $7,640.64 / $10,520.32
| Facility | | $6,850.20 | $7,640.64 | $10,520.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,388.64 / $8,247.00
| Facility | | $954.00 | $3,388.64 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.32 / $487.45 / $1,544.00
| Professional | | $355.32 | $487.45 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.10 / $236.10 / $1,122.09
| Professional | | $236.10 | $236.10 | $1,122.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.32 / $614.32 / $614.32
| Facility | | $614.32 | $614.32 | $614.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.25 / $532.64 / $943.77
| Professional | | $370.25 | $532.64 | $943.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.06 / $375.25 / $460.22
| Facility | | $354.06 | $375.25 | $460.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.78 / $443.45 / $482.74
| Professional | | $352.78 | $443.45 | $482.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $5,678.00
| Facility | | $1,175.00 | $2,715.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.28 / $564.72 / $919.60
| Professional | | $412.28 | $564.72 | $919.60 |