- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.05 / $1,042.54 / $7,629.00
| Facility | | $298.05 | $1,042.54 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $754.02 / $1,008.57 / $1,074.82
| Professional | | $754.02 | $1,008.57 | $1,074.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.48 / $386.54 / $386.54
| Professional | | $372.48 | $386.54 | $386.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.59 / $985.87 / $1,806.03
| Professional | | $344.59 | $985.87 | $1,806.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.33 / $626.33 / $626.33
| Professional | | $626.33 | $626.33 | $626.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.88 / $735.70 / $1,219.07
| Facility | | $597.88 | $735.70 | $1,219.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.65 / $1,255.18 / $8,017.00
| Facility | | $591.65 | $1,255.18 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $754.02 / $1,008.57 / $1,544.00
| Professional | | $754.02 | $1,008.57 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $387.90 / $525.79
| Professional | | $10.00 | $387.90 | $525.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.59 / $989.96 / $1,768.04
| Professional | | $344.59 | $989.96 | $1,768.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.63 / $351.40 / $351.40
| Facility | | $301.63 | $351.40 | $351.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.11 / $328.08 / $351.40
| Professional | | $138.11 | $328.08 | $351.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $3,742.00
| Facility | | $144.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.04 / $439.64 / $692.87
| Professional | | $305.04 | $439.64 | $692.87 |