- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.82 / $1,245.00 / $7,278.00
| Facility | | $290.82 | $1,245.00 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $268.37 / $404.01 / $712.21
| Professional | | $268.37 | $404.01 | $712.21 |
- 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
- $380.99 / $570.84 / $1,035.61
| Professional | | $380.99 | $570.84 | $1,035.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,438.74
| Facility | | $530.04 | $530.04 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.87 / $495.77 / $930.93
| Professional | | $340.87 | $495.77 | $930.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.72 / $505.48 / $746.00
| Facility | | $285.72 | $505.48 | $746.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.78 / $554.00 / $600.00
| Professional | | $505.78 | $554.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $571.70 / $1,170.40
| Professional | | $3.00 | $571.70 | $1,170.40 |
- 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
- $365.51 / $502.58 / $1,066.43
| Professional | | $365.51 | $502.58 | $1,066.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,349.92 / $1,492.17 / $16,394.00
| Facility | | $1,349.92 | $1,492.17 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,153.04 / $3,145.60 / $3,622.35
| Professional | | $2,153.04 | $3,145.60 | $3,622.35 |