- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.14 / $1,932.00 / $3,469.00
| Facility | | $268.14 | $1,932.00 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.46 / $340.34 / $578.99
| Professional | | $242.46 | $340.34 | $578.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.16 / $3,221.57 / $16,394.00
| Facility | | $641.16 | $3,221.57 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.02 / $647.27 / $2,617.36
| Professional | | $289.02 | $647.27 | $2,617.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.38 / $391.13 / $697.64
| Facility | | $304.38 | $391.13 | $697.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.15 / $728.30 / $1,620.25
| Professional | | $499.15 | $728.30 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $652.29 / $3,103.98
| Facility | | $593.00 | $652.29 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.00 / $531.73 / $1,059.34
| Professional | | $290.00 | $531.73 | $1,059.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.66 / $555.02 / $6,679.00
| Facility | | $259.66 | $555.02 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.69 / $546.60 / $782.75
| Professional | | $421.69 | $546.60 | $782.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.26 / $690.64 / $991.63
| Professional | | $369.26 | $690.64 | $991.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.00 / $4,006.00 / $16,394.00
| Facility | | $1,591.00 | $4,006.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.89 / $866.79 / $2,617.36
| Professional | | $379.89 | $866.79 | $2,617.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.00 / $4,006.00 / $10,764.00
| Facility | | $1,591.00 | $4,006.00 | $10,764.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.42 / $516.29 / $1,213.24
| Professional | | $340.42 | $516.29 | $1,213.24 |