- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.28 / $5,048.00 / $10,767.00
| Facility | | $332.28 | $5,048.00 | $10,767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.72 / $332.28 / $338.96
| Professional | | $228.72 | $332.28 | $338.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,525.00 / $11,065.00 / $12,418.00
| Facility | | $8,525.00 | $11,065.00 | $12,418.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.43 / $335.25 / $467.28
| Professional | | $266.43 | $335.25 | $467.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.64 / $424.08 / $738.35
| Professional | | $378.64 | $424.08 | $738.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.01 / $412.00 / $755.20
| Professional | | $288.01 | $412.00 | $755.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.68 / $311.61 / $377.58
| Professional | | $259.68 | $311.61 | $377.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.72 / $356.36 / $543.07
| Facility | | $274.72 | $356.36 | $543.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.35 / $502.00 / $3,079.00
| Professional | | $280.35 | $502.00 | $3,079.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.14 / $457.46 / $4,462.00
| Facility | | $283.14 | $457.46 | $4,462.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.14 / $457.46 / $4,462.00
| Professional | | $283.14 | $457.46 | $4,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.73 / $370.82 / $617.16
| Professional | | $231.73 | $370.82 | $617.16 |