- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.41 / $1,020.00 / $8,413.00
| Facility | | $588.41 | $1,020.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.58 / $610.97 / $1,112.38
| Professional | | $540.58 | $610.97 | $1,112.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $797.87 / $1,366.21 / $1,683.34
| Professional | | $797.87 | $1,366.21 | $1,683.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.84 / $1,003.01 / $1,493.83
| Professional | | $675.84 | $1,003.01 | $1,493.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.41 / $858.00 / $1,344.86
| Facility | | $588.41 | $858.00 | $1,344.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $731.00 / $786.00
| Professional | | $579.00 | $731.00 | $786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $948.28 / $1,625.00
| Professional | | $3.00 | $948.28 | $1,625.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,470.62 / $9,447.00 / $14,257.00
| Facility | | $2,470.62 | $9,447.00 | $14,257.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.04 / $856.46 / $1,573.33
| Professional | | $536.04 | $856.46 | $1,573.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,273.71 / $8,957.00 / $26,542.00
| Facility | | $2,273.71 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,236.95 / $5,472.30 / $5,472.30
| Professional | | $5,236.95 | $5,472.30 | $5,472.30 |