- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.39 / $497.05 / $882.00
| Professional | | $391.39 | $497.05 | $882.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.17 / $496.21 / $792.89
| Professional | | $478.17 | $496.21 | $792.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.40 / $589.82 / $968.97
| Professional | | $431.40 | $589.82 | $968.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.41 / $764.64 / $779.11
| Professional | | $576.41 | $764.64 | $779.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.00 / $533.98 / $2,478.00
| Professional | | $425.00 | $533.98 | $2,478.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $472.40 / $1,308.80
| Professional | | $5.00 | $472.40 | $1,308.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.03 / $597.97 / $1,005.84
| Professional | | $449.03 | $597.97 | $1,005.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.94 / $479.12 / $479.12
| Facility | | $402.94 | $479.12 | $479.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.94 / $479.12 / $513.84
| Professional | | $402.94 | $479.12 | $513.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.14 / $559.36 / $920.29
| Professional | | $389.14 | $559.36 | $920.29 |