- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.26 / $2,079.00 / $3,625.00
| Facility | | $336.26 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.45 / $341.15 / $500.39
| Professional | | $308.45 | $341.15 | $500.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,338.00 / $12,000.00
| Facility | | $669.00 | $2,338.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.36 / $643.35 / $2,412.71
| Professional | | $356.36 | $643.35 | $2,412.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.37 / $928.83 / $928.83
| Professional | | $452.37 | $928.83 | $928.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $2,467.03
| Facility | | $443.00 | $500.00 | $2,467.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.51 / $550.08 / $1,035.83
| Professional | | $348.51 | $550.08 | $1,035.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.10 / $708.56 / $6,679.00
| Facility | | $330.10 | $708.56 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.79 / $478.65 / $743.08
| Professional | | $378.79 | $478.65 | $743.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.83 / $810.98 / $1,047.21
| Professional | | $410.83 | $810.98 | $1,047.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $3,649.00 / $12,000.00
| Facility | | $822.00 | $3,649.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.07 / $650.96 / $2,412.71
| Professional | | $376.07 | $650.96 | $2,412.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,338.00 / $4,952.00
| Facility | | $669.00 | $2,338.00 | $4,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.63 / $514.32 / $1,127.10
| Professional | | $351.63 | $514.32 | $1,127.10 |