- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.31 / $5,412.00 / $10,767.00
| Facility | | $366.31 | $5,412.00 | $10,767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.16 / $351.23 / $414.00
| Professional | | $304.16 | $351.23 | $414.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,955.00 / $11,210.00 / $17,424.00
| Facility | | $8,955.00 | $11,210.00 | $17,424.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.19 / $364.70 / $500.18
| Professional | | $285.19 | $364.70 | $500.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.24 / $498.63 / $7,369.00
| Professional | | $342.24 | $498.63 | $7,369.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.95 / $437.01 / $768.34
| Professional | | $308.95 | $437.01 | $768.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.20 / $353.05 / $435.43
| Professional | | $294.20 | $353.05 | $435.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.23 / $431.06 / $642.75
| Facility | | $351.23 | $431.06 | $642.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.00 / $445.00 / $722.90
| Professional | | $392.00 | $445.00 | $722.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.10 / $427.02 / $5,122.00
| Facility | | $328.10 | $427.02 | $5,122.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.10 / $427.02 / $5,122.00
| Professional | | $328.10 | $427.02 | $5,122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,373.00 / $17,192.00
| Facility | | $6,303.00 | $9,373.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.04 / $438.43 / $671.85
| Professional | | $255.04 | $438.43 | $671.85 |