- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.29 / $4,390.00 / $9,475.46
| Facility | | $252.29 | $4,390.00 | $9,475.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.76 / $2,004.00 / $4,749.34
| Professional | | $212.76 | $2,004.00 | $4,749.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,160.00 / $18,351.00 / $19,756.00
| Facility | | $14,160.00 | $18,351.00 | $19,756.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.27 / $253.49 / $423.17
| Professional | | $201.27 | $253.49 | $423.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.50 / $236.72 / $916.00
| Professional | | $235.50 | $236.72 | $916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.23 / $369.23 / $640.00
| Facility | | $369.23 | $369.23 | $640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.88 / $601.74 / $6,782.70
| Professional | | $229.88 | $601.74 | $6,782.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,676.31 / $3,463.46 / $4,093.18
| Professional | | $2,676.31 | $3,463.46 | $4,093.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.29 / $2,610.52 / $6,329.52
| Facility | | $252.29 | $2,610.52 | $6,329.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,785.00 / $5,459.00 / $7,031.58
| Professional | | $3,785.00 | $5,459.00 | $7,031.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.15 / $299.99 / $982.00
| Facility | | $219.15 | $299.99 | $982.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,773.82 / $5,085.92 / $7,913.09
| Professional | | $2,773.82 | $5,085.92 | $7,913.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.00 / $1,045.00 / $2,375.00
| Facility | | $231.00 | $1,045.00 | $2,375.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,016.51 / $5,106.85 / $7,995.97
| Professional | | $3,016.51 | $5,106.85 | $7,995.97 |