- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.19 / $2,219.67 / $8,413.00
| Facility | | $283.19 | $2,219.67 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.76 / $427.97 / $792.42
| Professional | | $269.76 | $427.97 | $792.42 |
- 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
- $386.75 / $604.33 / $1,124.16
| Professional | | $386.75 | $604.33 | $1,124.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.26 / $524.53 / $973.26
| Professional | | $336.26 | $524.53 | $973.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.60 / $526.89 / $834.00
| Facility | | $286.60 | $526.89 | $834.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.99 / $583.00 / $606.00
| Professional | | $530.99 | $583.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $610.79 / $1,250.40
| Professional | | $3.00 | $610.79 | $1,250.40 |
- 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
- $387.92 / $540.02 / $1,123.29
| Professional | | $387.92 | $540.02 | $1,123.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,376.20 / $1,523.47 / $26,542.00
| Facility | | $1,376.20 | $1,523.47 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,188.88 / $3,341.28 / $3,875.85
| Professional | | $2,188.88 | $3,341.28 | $3,875.85 |