- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.13 / $2,618.00 / $4,410.00
| Facility | | $327.13 | $2,618.00 | $4,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.37 / $421.65 / $678.40
| Professional | | $306.37 | $421.65 | $678.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.30 / $2,427.17 / $26,542.00
| Facility | | $838.30 | $2,427.17 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.42 / $921.03 / $3,910.96
| Professional | | $425.42 | $921.03 | $3,910.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.13 / $539.87 / $962.94
| Facility | | $420.13 | $539.87 | $962.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $688.97 / $1,079.68 / $1,620.25
| Professional | | $688.97 | $1,079.68 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.00 / $748.00 / $3,103.98
| Facility | | $680.00 | $748.00 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.99 / $730.75 / $1,548.79
| Professional | | $390.99 | $730.75 | $1,548.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.64 / $766.06 / $6,679.00
| Facility | | $353.64 | $766.06 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.74 / $810.32 / $1,163.35
| Professional | | $626.74 | $810.32 | $1,163.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.29 / $960.39 / $1,472.49
| Professional | | $513.29 | $960.39 | $1,472.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $26,542.00
| Facility | | $1,061.00 | $2,854.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.48 / $1,279.59 / $3,910.96
| Professional | | $538.48 | $1,279.59 | $3,910.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.69 / $747.50 / $1,684.02
| Professional | | $497.69 | $747.50 | $1,684.02 |