- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.16 / $2,070.00 / $7,629.00
| Facility | | $450.16 | $2,070.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.07 / $371.04 / $494.05
| Professional | | $304.07 | $371.04 | $494.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.61 / $533.29 / $779.41
| Professional | | $370.61 | $533.29 | $779.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.81 / $504.51 / $781.03
| Professional | | $367.81 | $504.51 | $781.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.58 / $653.29 / $659.37
| Professional | | $493.58 | $653.29 | $659.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,326.00 / $8,017.00
| Facility | | $617.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.42 / $412.27 / $1,541.00
| Professional | | $314.42 | $412.27 | $1,541.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $995.10 / $1,102.00
| Professional | | $7.00 | $995.10 | $1,102.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.34 / $512.92 / $815.23
| Professional | | $371.34 | $512.92 | $815.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.30 / $406.65 / $963.15
| Facility | | $333.30 | $406.65 | $963.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.30 / $395.59 / $630.71
| Professional | | $333.30 | $395.59 | $630.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.38 / $527.54 / $854.74
| Professional | | $416.38 | $527.54 | $854.74 |