- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.20 / $3,494.00 / $7,799.00
| Facility | | $555.20 | $3,494.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.31 / $438.56 / $625.91
| Professional | | $331.31 | $438.56 | $625.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.37 / $529.63 / $529.63
| Professional | | $510.37 | $529.63 | $529.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.91 / $493.94 / $806.08
| Professional | | $348.91 | $493.94 | $806.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.76 / $796.84 / $823.45
| Professional | | $619.76 | $796.84 | $823.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $887.86 / $1,482.07 / $3,056.11
| Facility | | $887.86 | $1,482.07 | $3,056.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.46 / $503.36 / $1,820.00
| Professional | | $352.46 | $503.36 | $1,820.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.50 / $477.50 / $505.60
| Professional | | $477.50 | $477.50 | $505.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.94 / $612.94 / $612.94
| Facility | | $612.94 | $612.94 | $612.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.09 / $506.87 / $822.32
| Professional | | $360.09 | $506.87 | $822.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.41 / $413.46 / $504.49
| Facility | | $352.41 | $413.46 | $504.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.37 / $418.57 / $542.47
| Professional | | $352.37 | $418.57 | $542.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $4,300.00
| Facility | | $144.00 | $650.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.89 / $562.62 / $991.84
| Professional | | $426.89 | $562.62 | $991.84 |