- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.51 / $2,070.00 / $7,197.00
| Facility | | $546.51 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.92 / $492.71 / $713.84
| Professional | | $432.92 | $492.71 | $713.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.14 / $549.11 / $919.30
| Professional | | $529.14 | $549.11 | $919.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.70 / $834.70 / $834.70
| Facility | | $834.70 | $834.70 | $834.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.78 / $599.01 / $991.38
| Professional | | $455.78 | $599.01 | $991.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $632.64 / $854.70 / $1,092.75
| Professional | | $632.64 | $854.70 | $1,092.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,266.00 / $8,017.00
| Facility | | $641.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.24 / $533.97 / $1,544.00
| Professional | | $438.24 | $533.97 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.50 / $579.50 / $1,084.40
| Professional | | $579.50 | $579.50 | $1,084.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.70 / $834.70 / $834.70
| Facility | | $834.70 | $834.70 | $834.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.16 / $611.25 / $1,014.73
| Professional | | $456.16 | $611.25 | $1,014.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.00 / $479.27 / $511.83
| Facility | | $422.00 | $479.27 | $511.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.52 / $498.94 / $547.35
| Professional | | $466.52 | $498.94 | $547.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.17 / $619.73 / $1,011.03
| Professional | | $452.17 | $619.73 | $1,011.03 |