- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.12 / $1,682.46 / $7,563.26
| Facility | | $471.12 | $1,682.46 | $7,563.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.95 / $539.25 / $1,245.00
| Professional | | $318.95 | $539.25 | $1,245.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.32 / $557.32 / $557.32
| Professional | | $557.32 | $557.32 | $557.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.43 / $732.16 / $1,366.51
| Professional | | $406.43 | $732.16 | $1,366.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,215.60
| Facility | | $530.04 | $530.04 | $1,215.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.62 / $670.22 / $1,152.28
| Professional | | $392.62 | $670.22 | $1,152.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.44 / $645.00 / $1,156.00
| Facility | | $323.44 | $645.00 | $1,156.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $622.00 / $707.00
| Professional | | $507.00 | $622.00 | $707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.06 / $732.30 / $990.09
| Professional | | $478.06 | $732.30 | $990.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.51 / $697.69 / $1,272.83
| Professional | | $467.51 | $697.69 | $1,272.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,562.96 / $1,745.29 / $16,394.00
| Facility | | $1,562.96 | $1,745.29 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,460.88 / $3,944.88 / $4,672.43
| Professional | | $2,460.88 | $3,944.88 | $4,672.43 |