- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.52 / $2,537.00 / $4,410.00
| Facility | | $363.52 | $2,537.00 | $4,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.50 / $450.07 / $816.93
| Professional | | $282.50 | $450.07 | $816.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.61 / $2,410.09 / $26,542.00
| Facility | | $787.61 | $2,410.09 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.82 / $815.96 / $3,452.56
| Professional | | $370.82 | $815.96 | $3,452.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.31 / $491.27 / $876.25
| Facility | | $382.31 | $491.27 | $876.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.08 / $626.91 / $1,047.52
| Professional | | $275.08 | $626.91 | $1,047.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.00 / $748.00 / $3,111.82
| Facility | | $680.00 | $748.00 | $3,111.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.13 / $683.74 / $1,365.36
| Professional | | $369.13 | $683.74 | $1,365.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.88 / $697.10 / $6,679.00
| Facility | | $321.88 | $697.10 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.03 / $718.31 / $1,032.10
| Professional | | $556.03 | $718.31 | $1,032.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.73 / $882.61 / $1,479.22
| Professional | | $471.73 | $882.61 | $1,479.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,569.40 / $4,436.96 / $4,501.87
| Facility | | $1,569.40 | $4,436.96 | $4,501.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.10 / $504.61 / $787.63
| Professional | | $504.10 | $504.61 | $787.63 |
- 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
- $508.60 / $1,152.19 / $3,452.56
| Professional | | $508.60 | $1,152.19 | $3,452.56 |
- 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
- $476.70 / $727.42 / $1,481.53
| Professional | | $476.70 | $727.42 | $1,481.53 |