- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.04 / $2,747.00 / $4,806.64
| Facility | | $324.04 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.04 / $386.56 / $637.97
| Professional | | $324.04 | $386.56 | $637.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.38 / $921.97 / $2,713.00
| Facility | | $417.38 | $921.97 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.87 / $738.61 / $2,968.96
| Professional | | $369.87 | $738.61 | $2,968.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.51 / $572.48 / $1,022.00
| Facility | | $445.51 | $572.48 | $1,022.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.87 / $763.65 / $1,110.46
| Professional | | $499.87 | $763.65 | $1,110.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.83 / $639.16 / $1,109.34
| Professional | | $390.83 | $639.16 | $1,109.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.89 / $812.34 / $6,679.00
| Facility | | $371.89 | $812.34 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.14 / $581.05 / $802.08
| Professional | | $477.14 | $581.05 | $802.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.93 / $926.93 / $1,197.53
| Professional | | $457.93 | $926.93 | $1,197.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $649.74 / $649.74 / $649.74
| Professional | | $649.74 | $649.74 | $649.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,818.00 / $3,445.00
| Facility | | $55.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.35 / $810.06 / $2,968.96
| Professional | | $418.35 | $810.06 | $2,968.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.24 / $625.75 / $1,231.99
| Professional | | $413.24 | $625.75 | $1,231.99 |