- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.39 / $2,067.00 / $3,625.00
| Facility | | $331.39 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.05 / $331.39 / $547.41
| Professional | | $248.05 | $331.39 | $547.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.19 / $2,411.51 / $10,821.00
| Facility | | $494.19 | $2,411.51 | $10,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.74 / $509.69 / $1,981.04
| Professional | | $221.74 | $509.69 | $1,981.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.06 / $317.27 / $559.87
| Facility | | $244.06 | $317.27 | $559.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.97 / $506.84 / $608.63
| Professional | | $331.97 | $506.84 | $608.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.89 / $552.04 / $1,059.32
| Professional | | $326.89 | $552.04 | $1,059.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.94 / $445.02 / $6,679.00
| Facility | | $208.94 | $445.02 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.57 / $400.03 / $715.22
| Professional | | $316.57 | $400.03 | $715.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.36 / $551.82 / $745.66
| Professional | | $257.36 | $551.82 | $745.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.04 / $3,649.00 / $12,000.00
| Facility | | $1,403.04 | $3,649.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.87 / $816.65 / $1,981.04
| Professional | | $350.87 | $816.65 | $1,981.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.02 / $475.07 / $1,073.27
| Professional | | $340.02 | $475.07 | $1,073.27 |