- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.27 / $2,675.00 / $8,413.00
| Facility | | $433.27 | $2,675.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.86 / $456.76 / $968.03
| Professional | | $398.86 | $456.76 | $968.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.04 / $604.04 / $604.04
| Professional | | $604.04 | $604.04 | $604.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.04 / $681.38 / $1,257.17
| Professional | | $498.04 | $681.38 | $1,257.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,438.74
| Facility | | $606.10 | $606.10 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.48 / $629.11 / $1,095.29
| Professional | | $477.48 | $629.11 | $1,095.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.27 / $528.21 / $979.19
| Facility | | $433.27 | $528.21 | $979.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $528.21 / $547.00 / $606.00
| Professional | | $528.21 | $547.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $595.20 / $1,176.20
| Professional | | $3.00 | $595.20 | $1,176.20 |
- 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
- $373.66 / $519.73 / $1,067.88
| Professional | | $373.66 | $519.73 | $1,067.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,680.84 / $4,754.80 / $26,542.00
| Facility | | $1,680.84 | $4,754.80 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,866.78 / $4,180.57 / $4,180.57
| Professional | | $3,866.78 | $4,180.57 | $4,180.57 |