- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.74 / $2,825.44 / $7,993.00
| Facility | | $432.74 | $2,825.44 | $7,993.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.81 / $450.50 / $973.08
| Professional | | $287.81 | $450.50 | $973.08 |
- 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
- $385.45 / $616.11 / $1,141.23
| Professional | | $385.45 | $616.11 | $1,141.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,438.74
| Facility | | $606.10 | $606.10 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.40 / $530.99 / $995.60
| Professional | | $362.40 | $530.99 | $995.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.56 / $540.60 / $802.00
| Facility | | $299.56 | $540.60 | $802.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.66 / $591.00 / $606.00
| Professional | | $543.66 | $591.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $612.00 / $1,264.20
| Professional | | $3.00 | $612.00 | $1,264.20 |
- 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
- $391.84 / $546.99 / $1,203.25
| Professional | | $391.84 | $546.99 | $1,203.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,439.04 / $1,589.45 / $26,542.00
| Facility | | $1,439.04 | $1,589.45 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,291.12 / $3,359.92 / $3,887.18
| Professional | | $2,291.12 | $3,359.92 | $3,887.18 |