- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.84 / $4,500.22 / $9,539.00
| Facility | | $328.84 | $4,500.22 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.22 / $293.95 / $571.41
| Professional | | $255.22 | $293.95 | $571.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.08 / $321.08 / $456.67
| Professional | | $251.08 | $321.08 | $456.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.60 / $293.04 / $1,729.50
| Professional | | $292.60 | $293.04 | $1,729.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.14 / $988.00 / $3,282.37
| Facility | | $306.14 | $988.00 | $3,282.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.75 / $345.78 / $575.41
| Professional | | $263.75 | $345.78 | $575.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.22 / $325.27 / $452.40
| Professional | | $260.22 | $325.27 | $452.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.39 / $353.00 / $523.12
| Facility | | $275.39 | $353.00 | $523.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.00 / $371.00 / $638.16
| Professional | | $328.00 | $371.00 | $638.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.16 / $336.63 / $624.04
| Facility | | $270.16 | $336.63 | $624.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.16 / $336.63 / $624.04
| Professional | | $270.16 | $336.63 | $624.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $908.00 / $5,815.00 / $12,680.00
| Facility | | $908.00 | $5,815.00 | $12,680.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.40 / $325.27 / $505.18
| Professional | | $206.40 | $325.27 | $505.18 |