- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.51 / $1,245.00 / $8,413.00
| Facility | | $411.51 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.51 / $427.29 / $815.76
| Professional | | $411.51 | $427.29 | $815.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.91 / $731.79 / $1,201.50
| Professional | | $479.91 | $731.79 | $1,201.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.64 / $658.29 / $1,175.28
| Professional | | $490.64 | $658.29 | $1,175.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.51 / $577.00 / $930.01
| Facility | | $411.51 | $577.00 | $930.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.00 / $530.00 / $606.00
| Professional | | $530.00 | $530.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $545.29 / $1,266.50
| Professional | | $4.00 | $545.29 | $1,266.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.25 / $567.77 / $1,114.20
| Professional | | $403.25 | $567.77 | $1,114.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,928.20 / $8,957.00 / $26,542.00
| Facility | | $1,928.20 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,328.91 / $3,328.91 / $3,496.20
| Professional | | $3,328.91 | $3,328.91 | $3,496.20 |