- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.00 / $2,671.00 / $4,712.00
| Facility | | $1,015.00 | $2,671.00 | $4,712.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.91 / $450.86 / $1,165.69
| Professional | | $379.91 | $450.86 | $1,165.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.10 / $2,826.85 / $8,498.00
| Facility | | $941.10 | $2,826.85 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.31 / $759.41 / $4,180.57
| Professional | | $441.31 | $759.41 | $4,180.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.51 / $890.19 / $1,202.16
| Professional | | $598.51 | $890.19 | $1,202.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.22 / $738.52 / $1,270.89
| Professional | | $465.22 | $738.52 | $1,270.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.92 / $986.72 / $6,679.00
| Facility | | $453.92 | $986.72 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.87 / $630.95 / $868.31
| Professional | | $520.87 | $630.95 | $868.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $561.55 / $1,113.24 / $1,468.54
| Professional | | $561.55 | $1,113.24 | $1,468.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.71 / $3,863.50 / $4,320.31
| Facility | | $732.71 | $3,863.50 | $4,320.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.03 / $711.07 / $826.39
| Professional | | $352.03 | $711.07 | $826.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,592.00 / $26,542.00
| Facility | | $1,640.00 | $3,592.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.16 / $831.46 / $4,180.57
| Professional | | $478.16 | $831.46 | $4,180.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.34 / $689.61 / $1,329.88
| Professional | | $458.34 | $689.61 | $1,329.88 |