- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $660.69 / $14,454.40
| Facility | | $288.40 | $660.69 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $354.81 / $1,047.13
| Professional | | $269.15 | $354.81 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $562.34 / $1,380.38
| Professional | | $295.12 | $562.34 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,000.00 / $1,584.89
| Facility | | $851.14 | $1,000.00 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $954.99 / $1,479.11
| Professional | | $346.74 | $954.99 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $436.52 / $3,162.28
| Facility | | $295.12 | $436.52 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $741.31 / $933.25
| Professional | | $549.54 | $741.31 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $467.74 / $1,513.56
| Facility | | $295.12 | $467.74 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $588.84 / $2,344.23
| Professional | | $302.00 | $588.84 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $354.81
| Professional | | $32.36 | $33.11 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $831.76 / $1,148.15
| Professional | | $537.03 | $831.76 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,819.70 / $1,819.70
| Facility | | $776.25 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $537.03 / $537.03 / $1,258.93
| Facility | 54 | $537.03 | $537.03 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $1,479.11 / $2,344.23
| Professional | | $512.86 | $1,479.11 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $1,905.46 / $2,041.74
| Professional | | $616.60 | $1,905.46 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,548.82 / $1,949.84
| Facility | | $977.24 | $1,548.82 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $436.52 / $1,202.26
| Professional | | $281.84 | $436.52 | $1,202.26 |