- 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
- $476.50 / $544.17 / $634.65
| Professional | | $476.50 | $544.17 | $634.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.75 / $590.42 / $858.38
| Professional | | $400.75 | $590.42 | $858.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.92 / $619.94 / $962.56
| Professional | | $438.92 | $619.94 | $962.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $692.38 / $692.38 / $731.85
| Professional | | $692.38 | $692.38 | $731.85 |
- 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
- $437.24 / $566.41 / $2,467.00
| Professional | | $437.24 | $566.41 | $2,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $558.90 / $1,123.09
| Professional | | $3.00 | $558.90 | $1,123.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.08 / $636.84 / $962.56
| Professional | | $473.08 | $636.84 | $962.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.58 / $443.58 / $475.18
| Facility | | $443.58 | $443.58 | $475.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.37 / $452.45 / $475.18
| Professional | | $423.37 | $452.45 | $475.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,765.24 / $10,130.54
| Facility | | $2,332.00 | $4,765.24 | $10,130.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.31 / $587.99 / $937.72
| Professional | | $449.31 | $587.99 | $937.72 |