- 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
- $425.85 / $474.68 / $784.86
| Professional | | $425.85 | $474.68 | $784.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.18 / $515.94 / $515.94
| Professional | | $497.18 | $515.94 | $515.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.33 / $618.71 / $1,047.74
| Professional | | $427.33 | $618.71 | $1,047.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.33 / $808.41 / $808.41
| Professional | | $604.33 | $808.41 | $808.41 |
- 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
- $441.45 / $510.73 / $1,659.00
| Professional | | $441.45 | $510.73 | $1,659.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $534.60 / $1,269.50
| Professional | | $5.00 | $534.60 | $1,269.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.04 / $625.16 / $1,047.74
| Professional | | $478.04 | $625.16 | $1,047.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.66 / $482.83 / $508.40
| Facility | | $453.66 | $482.83 | $508.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.66 / $487.10 / $512.55
| Professional | | $453.66 | $487.10 | $512.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.77 / $609.72 / $976.04
| Professional | | $440.77 | $609.72 | $976.04 |