- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.78 / $5,087.00 / $8,294.00
| Facility | | $671.78 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.51 / $394.28 / $610.55
| Professional | | $364.51 | $394.28 | $610.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,823.00 / $12,004.00 / $15,528.00
| Facility | | $9,823.00 | $12,004.00 | $15,528.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.06 / $459.42 / $759.55
| Professional | | $355.06 | $459.42 | $759.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.17 / $432.37 / $7,889.00
| Professional | | $420.17 | $432.37 | $7,889.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.04 / $443.04 / $640.00
| Facility | | $443.04 | $443.04 | $640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.48 / $541.11 / $858.22
| Professional | | $379.48 | $541.11 | $858.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.98 / $479.97 / $554.97
| Professional | | $374.98 | $479.97 | $554.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.57 / $542.51 / $808.95
| Facility | | $396.57 | $542.51 | $808.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.00 / $578.36 / $771.00
| Professional | | $498.00 | $578.36 | $771.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.94 / $536.22 / $1,842.57
| Facility | | $386.94 | $536.22 | $1,842.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.94 / $538.54 / $1,842.57
| Professional | | $386.94 | $538.54 | $1,842.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.00 / $13,024.00 / $26,537.00
| Facility | | $7,408.00 | $13,024.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.02 / $501.92 / $746.97
| Professional | | $322.02 | $501.92 | $746.97 |