- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.81 / $2,747.00 / $8,104.00
| Facility | | $415.81 | $2,747.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.31 / $372.37 / $616.59
| Professional | | $330.31 | $372.37 | $616.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.75 / $421.06 / $477.52
| Professional | | $405.75 | $421.06 | $477.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.67 / $613.67 / $613.67
| Facility | | $613.67 | $613.67 | $613.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.39 / $440.65 / $735.22
| Professional | | $330.39 | $440.65 | $735.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.24 / $654.52 / $839.88
| Professional | | $486.24 | $654.52 | $839.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.75 / $607.30 / $10,070.00
| Facility | | $552.75 | $607.30 | $10,070.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.43 / $420.43 / $420.43
| Professional | | $420.43 | $420.43 | $420.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.46 / $3,839.00 / $8,427.00
| Facility | | $604.46 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.93 / $409.60 / $856.57
| Professional | | $330.93 | $409.60 | $856.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.20 / $480.40 / $817.50
| Professional | | $390.20 | $480.40 | $817.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.67 / $613.67 / $613.67
| Facility | | $613.67 | $613.67 | $613.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.69 / $448.23 / $743.51
| Professional | | $343.69 | $448.23 | $743.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.13 / $357.75 / $396.65
| Facility | | $353.13 | $357.75 | $396.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.54 / $384.16 / $420.96
| Professional | | $352.54 | $384.16 | $420.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.60 / $459.30 / $755.69
| Professional | | $337.60 | $459.30 | $755.69 |