- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.97 / $644.63 / $7,724.00
| Facility | | $261.97 | $644.63 | $7,724.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.43 / $405.20 / $723.46
| Professional | | $255.43 | $405.20 | $723.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.57 / $364.57 / $364.57
| Professional | | $364.57 | $364.57 | $364.57 |
- 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
- $340.88 / $562.45 / $1,034.34
| Professional | | $340.88 | $562.45 | $1,034.34 |
- 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
- $322.89 / $479.67 / $895.50
| Professional | | $322.89 | $479.67 | $895.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.83 / $486.24 / $706.72
| Facility | | $265.83 | $486.24 | $706.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.64 / $534.00 / $606.00
| Professional | | $491.64 | $534.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $556.20 / $1,149.09
| Professional | | $3.00 | $556.20 | $1,149.09 |
- 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
- $354.44 / $493.53 / $1,026.33
| Professional | | $354.44 | $493.53 | $1,026.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.40 / $1,413.36 / $26,542.00
| Facility | | $1,272.40 | $1,413.36 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,024.40 / $3,043.20 / $3,523.58
| Professional | | $2,024.40 | $3,043.20 | $3,523.58 |