- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.69 / $672.47 / $7,278.00
| Facility | | $280.69 | $672.47 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.69 / $415.11 / $572.62
| Professional | | $280.69 | $415.11 | $572.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.47 / $1,657.11 / $2,812.07
| Facility | | $1,506.47 | $1,657.11 | $2,812.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.81 / $581.02 / $1,105.08
| Professional | | $351.81 | $581.02 | $1,105.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.89 / $2,844.33 / $5,654.79
| Facility | | $490.89 | $2,844.33 | $5,654.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.10 / $535.00 / $966.69
| Professional | | $332.10 | $535.00 | $966.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.69 / $432.59 / $723.93
| Facility | | $280.69 | $432.59 | $723.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.00 / $556.00 / $1,107.11
| Professional | | $508.00 | $556.00 | $1,107.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.30 / $393.40 / $1,019.50
| Professional | | $327.30 | $393.40 | $1,019.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.00 / $2,050.00 / $15,712.00
| Facility | | $1,461.00 | $2,050.00 | $15,712.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.44 / $500.03 / $1,159.08
| Professional | | $364.44 | $500.03 | $1,159.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,021.28 / $2,021.28 / $16,394.00
| Facility | | $2,021.28 | $2,021.28 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,140.16 / $3,149.44 / $3,657.23
| Professional | | $2,140.16 | $3,149.44 | $3,657.23 |