- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.71 / $2,747.00 / $8,017.00
| Facility | | $428.71 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.52 / $372.11 / $566.59
| Professional | | $289.52 | $372.11 | $566.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.95 / $409.85 / $409.85
| Professional | | $394.95 | $409.85 | $409.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.20 / $454.39 / $730.17
| Professional | | $314.20 | $454.39 | $730.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.60 / $630.48 / $644.47
| Professional | | $475.60 | $630.48 | $644.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,178.52 / $1,178.52 / $6,850.20
| Facility | | $1,178.52 | $1,178.52 | $6,850.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,389.00 / $8,017.00
| Facility | | $934.00 | $3,389.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.07 / $419.49 / $945.02
| Professional | | $297.07 | $419.49 | $945.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $380.30 / $1,064.70
| Professional | | $5.00 | $380.30 | $1,064.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.80 / $464.43 / $750.06
| Professional | | $330.80 | $464.43 | $750.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.92 / $312.97 / $390.40
| Facility | | $294.92 | $312.97 | $390.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.80 / $383.45 / $418.64
| Professional | | $293.80 | $383.45 | $418.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,824.00 / $5,678.00
| Facility | | $1,175.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.83 / $493.91 / $778.28
| Professional | | $349.83 | $493.91 | $778.28 |