- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.39 / $733.94 / $7,278.00
| Facility | | $314.39 | $733.94 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.39 / $439.00 / $733.94
| Professional | | $314.39 | $439.00 | $733.94 |
- 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
- $201.18 / $642.49 / $1,127.09
| Professional | | $201.18 | $642.49 | $1,127.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.01 / $576.23 / $1,028.17
| Professional | | $389.01 | $576.23 | $1,028.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.39 / $540.54 / $830.00
| Facility | | $314.39 | $540.54 | $830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $608.00 / $608.00
| Professional | | $507.00 | $608.00 | $608.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $609.20 / $1,287.40
| Professional | | $3.00 | $609.20 | $1,287.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.38 / $552.14 / $1,172.32
| Professional | | $394.38 | $552.14 | $1,172.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,536.24 / $1,693.95 / $16,394.00
| Facility | | $1,536.24 | $1,693.95 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,425.12 / $3,598.25 / $3,918.53
| Professional | | $2,425.12 | $3,598.25 | $3,918.53 |