- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.52 / $901.00 / $7,278.00
| Facility | | $318.52 | $901.00 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.81 / $448.79 / $795.88
| Professional | | $301.81 | $448.79 | $795.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.83 / $1,704.83 / $1,729.70
| Facility | | $1,704.83 | $1,704.83 | $1,729.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.51 / $629.10 / $1,156.02
| Professional | | $288.51 | $629.10 | $1,156.02 |
- 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
- $387.29 / $566.66 / $1,044.61
| Professional | | $387.29 | $566.66 | $1,044.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.52 / $560.49 / $826.00
| Facility | | $318.52 | $560.49 | $826.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $610.00 / $625.00
| Professional | | $507.00 | $610.00 | $625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $639.90 / $1,296.90
| Professional | | $3.00 | $639.90 | $1,296.90 |
- 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
- $408.69 / $592.66 / $1,183.42
| Professional | | $408.69 | $592.66 | $1,183.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,524.28 / $1,683.78 / $16,394.00
| Facility | | $1,524.28 | $1,683.78 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,426.56 / $3,514.48 / $4,065.38
| Professional | | $2,426.56 | $3,514.48 | $4,065.38 |