- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.19 / $2,747.00 / $8,404.00
| Facility | | $432.19 | $2,747.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.18 / $385.40 / $597.96
| Professional | | $263.18 | $385.40 | $597.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.93 / $424.36 / $876.84
| Professional | | $408.93 | $424.36 | $876.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.20 / $478.20 / $478.20
| Facility | | $478.20 | $478.20 | $478.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.39 / $432.04 / $745.97
| Professional | | $289.39 | $432.04 | $745.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.33 / $642.89 / $838.30
| Professional | | $485.33 | $642.89 | $838.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.73 / $320.73 / $320.73
| Professional | | $320.73 | $320.73 | $320.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,534.00 / $8,451.00
| Facility | | $832.00 | $4,534.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.98 / $431.17 / $1,491.71
| Professional | | $270.98 | $431.17 | $1,491.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $545.90 / $679.10 / $922.30
| Professional | | $545.90 | $679.10 | $922.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.20 / $478.20 / $478.20
| Facility | | $478.20 | $478.20 | $478.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.75 / $443.41 / $753.83
| Professional | | $292.75 | $443.41 | $753.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.08 / $342.74 / $430.04
| Facility | | $272.08 | $342.74 | $430.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.42 / $396.09 / $430.15
| Professional | | $271.42 | $396.09 | $430.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.63 / $515.82 / $830.27
| Professional | | $403.63 | $515.82 | $830.27 |