- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,783.00 / $7,542.00
| Facility | | $652.00 | $2,783.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.80 / $361.38 / $616.05
| Professional | | $324.80 | $361.38 | $616.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,848.28 / $8,793.46 / $15,732.53
| Facility | | $2,848.28 | $8,793.46 | $15,732.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.50 / $375.72 / $592.75
| Professional | | $287.50 | $375.72 | $592.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $324.76 / $337.97
| Facility | | $80.00 | $324.76 | $337.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.65 / $405.65 / $405.65
| Facility | | $405.65 | $405.65 | $405.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.13 / $500.64 / $767.00
| Professional | | $361.13 | $500.64 | $767.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.44 / $16,394.00 / $19,913.50
| Facility | | $1,981.44 | $16,394.00 | $19,913.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,674.28 / $4,674.28 / $4,674.28
| Professional | | $4,674.28 | $4,674.28 | $4,674.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.26 / $508.01 / $797.15
| Facility | | $342.26 | $508.01 | $797.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.43 / $517.71 / $641.96
| Professional | | $431.43 | $517.71 | $641.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.90 / $672.90 / $672.90
| Professional | | $672.90 | $672.90 | $672.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.26 / $511.54 / $811.48
| Facility | | $342.26 | $511.54 | $811.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.90 / $510.89 / $767.35
| Professional | | $368.90 | $510.89 | $767.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,451.00 / $8,600.00
| Facility | | $1,154.00 | $3,451.00 | $8,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.37 / $392.58 / $634.26
| Professional | | $295.37 | $392.58 | $634.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.57 / $336.83 / $461.44
| Professional | | $294.57 | $336.83 | $461.44 |