- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.00 / $2,783.00 / $7,542.00
| Facility | | $661.00 | $2,783.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.73 / $514.41 / $895.05
| Professional | | $450.73 | $514.41 | $895.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.83 / $550.39 / $825.06
| Professional | | $413.83 | $550.39 | $825.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $497.77 / $509.71
| Facility | | $80.00 | $497.77 | $509.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.10 / $576.10 / $576.10
| Facility | | $576.10 | $576.10 | $576.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.36 / $684.84 / $1,036.82
| Professional | | $512.36 | $684.84 | $1,036.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,326.96 / $11,500.00 / $16,394.00
| Facility | | $3,326.96 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,617.60 / $3,700.56 / $4,396.35
| Professional | | $3,617.60 | $3,700.56 | $4,396.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493.49 / $642.34 / $993.00
| Facility | | $493.49 | $642.34 | $993.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.08 / $747.69 / $927.14
| Professional | | $623.08 | $747.69 | $927.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.50 / $724.50 / $724.50
| Professional | | $724.50 | $724.50 | $724.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493.49 / $643.58 / $1,028.04
| Facility | | $493.49 | $643.58 | $1,028.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.86 / $711.64 / $1,062.59
| Professional | | $514.86 | $711.64 | $1,062.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.02 / $549.95 / $877.69
| Professional | | $410.02 | $549.95 | $877.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.42 / $483.81 / $668.33
| Professional | | $425.42 | $483.81 | $668.33 |