- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.58 / $1,245.00 / $7,724.00
| Facility | | $422.58 | $1,245.00 | $7,724.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.57 / $586.36 / $1,021.63
| Professional | | $422.57 | $586.36 | $1,021.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.73 / $386.73 / $386.73
| Professional | | $386.73 | $386.73 | $386.73 |
- 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
- $530.66 / $814.16 / $1,423.80
| Professional | | $530.66 | $814.16 | $1,423.80 |
- 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
- $479.42 / $684.20 / $1,296.86
| Professional | | $479.42 | $684.20 | $1,296.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.58 / $698.98 / $1,023.23
| Facility | | $422.58 | $698.98 | $1,023.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $759.00 / $773.00
| Professional | | $579.00 | $759.00 | $773.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $792.00 / $1,637.30
| Professional | | $3.00 | $792.00 | $1,637.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.00 / $7,162.00 / $10,397.00
| Facility | | $1,711.00 | $7,162.00 | $10,397.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.53 / $698.12 / $1,348.35
| Professional | | $489.53 | $698.12 | $1,348.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.48 / $2,247.94 / $26,542.00
| Facility | | $2,024.48 | $2,247.94 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,220.00 / $4,353.28 / $5,031.53
| Professional | | $3,220.00 | $4,353.28 | $5,031.53 |