- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.49 / $1,894.00 / $17,823.00
| Facility | | $267.49 | $1,894.00 | $17,823.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.23 / $263.82 / $332.34
| Professional | | $226.23 | $263.82 | $332.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,139.00 / $3,168.00 / $5,962.00
| Facility | | $1,139.00 | $3,168.00 | $5,962.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.59 / $548.71 / $1,402.01
| Professional | | $231.59 | $548.71 | $1,402.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.79 / $747.65 / $1,146.92
| Facility | | $639.79 | $747.65 | $1,146.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.72 / $778.81 / $1,055.60
| Professional | | $276.72 | $778.81 | $1,055.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.73 / $316.14 / $483.38
| Facility | | $239.73 | $316.14 | $483.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.97 / $374.49 / $7,891.00
| Facility | | $235.97 | $374.49 | $7,891.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.99 / $521.26 / $1,800.24
| Professional | | $252.99 | $521.26 | $1,800.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $70.00 / $482.79
| Professional | | $50.00 | $70.00 | $482.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.97 / $312.95 / $483.38
| Facility | | $235.97 | $312.95 | $483.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.00 / $586.08 / $874.90
| Professional | | $444.00 | $586.08 | $874.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.02 / $7,909.30 / $7,909.30
| Facility | | $277.02 | $7,909.30 | $7,909.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.21 / $1,153.30 / $1,800.24
| Professional | | $335.21 | $1,153.30 | $1,800.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $924.08 / $924.08 / $924.08
| Professional | | $924.08 | $924.08 | $924.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,614.00 / $7,611.00 / $8,788.00
| Facility | | $4,614.00 | $7,611.00 | $8,788.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.89 / $505.15 / $1,040.84
| Professional | | $242.89 | $505.15 | $1,040.84 |