- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.58 / $2,747.00 / $8,017.00
| Facility | | $399.58 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.62 / $346.95 / $615.65
| Professional | | $274.62 | $346.95 | $615.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,824.00 / $4,354.00 / $8,459.92
| Facility | | $1,824.00 | $4,354.00 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.04 / $379.85 / $379.85
| Professional | | $366.04 | $379.85 | $379.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.76 / $428.76 / $691.11
| Professional | | $293.76 | $428.76 | $691.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.54 / $582.07 / $597.47
| Professional | | $439.54 | $582.07 | $597.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,182.98 / $6,473.09 / $9,494.82
| Facility | | $2,182.98 | $6,473.09 | $9,494.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,552.00 / $8,017.00
| Facility | | $934.00 | $3,552.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.58 / $383.86 / $1,186.75
| Professional | | $277.58 | $383.86 | $1,186.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $357.30 / $992.90
| Professional | | $5.00 | $357.30 | $992.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.33 / $430.50 / $710.82
| Professional | | $316.33 | $430.50 | $710.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.39 / $297.73 / $368.22
| Facility | | $276.39 | $297.73 | $368.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.13 / $356.40 / $388.86
| Professional | | $275.13 | $356.40 | $388.86 |
- 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
- $323.51 / $464.62 / $753.04
| Professional | | $323.51 | $464.62 | $753.04 |