- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.00 / $2,094.00 / $3,685.00
| Facility | | $988.00 | $2,094.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.27 / $441.24 / $1,019.07
| Professional | | $263.27 | $441.24 | $1,019.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.26 / $5,097.00 / $14,018.00
| Facility | | $817.26 | $5,097.00 | $14,018.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.86 / $654.15 / $2,691.04
| Professional | | $314.86 | $654.15 | $2,691.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.33 / $705.97 / $938.21
| Professional | | $422.33 | $705.97 | $938.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.70 / $764.58 / $1,358.86
| Professional | | $523.70 | $764.58 | $1,358.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.87 / $770.06 / $6,679.00
| Facility | | $364.87 | $770.06 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.46 / $529.05 / $945.93
| Professional | | $425.46 | $529.05 | $945.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.67 / $927.34 / $1,506.93
| Professional | | $463.67 | $927.34 | $1,506.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,139.38 / $1,139.38 / $1,153.58
| Professional | | $1,139.38 | $1,139.38 | $1,153.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,508.58 / $15,421.00
| Facility | | $55.00 | $5,508.58 | $15,421.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.95 / $736.55 / $2,691.04
| Professional | | $500.95 | $736.55 | $2,691.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $13,017.00
| Facility | | $2,386.00 | $5,904.00 | $13,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.02 / $642.49 / $1,277.08
| Professional | | $482.02 | $642.49 | $1,277.08 |