- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.03 / $1,659.00 / $8,017.00
| Facility | | $377.03 | $1,659.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.89 / $426.80 / $804.52
| Professional | | $298.89 | $426.80 | $804.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.41 / $496.46 / $512.47
| Professional | | $478.41 | $496.46 | $512.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.65 / $571.65 / $571.65
| Facility | | $571.65 | $571.65 | $571.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.91 / $466.18 / $827.34
| Professional | | $325.91 | $466.18 | $827.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.32 / $776.68 / $995.47
| Professional | | $576.32 | $776.68 | $995.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,710.43 / $5,597.41 / $16,522.79
| Facility | | $2,710.43 | $5,597.41 | $16,522.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.14 / $2,463.00 / $8,017.00
| Facility | | $514.14 | $2,463.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.67 / $481.80 / $1,125.61
| Professional | | $306.67 | $481.80 | $1,125.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.80 / $344.80 / $1,029.30
| Professional | | $344.80 | $344.80 | $1,029.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.65 / $571.65 / $571.65
| Facility | | $571.65 | $571.65 | $571.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.70 / $474.85 / $845.19
| Professional | | $329.70 | $474.85 | $845.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.20 / $327.33 / $473.40
| Facility | | $291.20 | $327.33 | $473.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.39 / $383.05 / $509.65
| Professional | | $318.39 | $383.05 | $509.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.85 / $556.61 / $868.63
| Professional | | $391.85 | $556.61 | $868.63 |