- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.00 / $2,747.00 / $8,017.00
| Facility | | $760.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.40 / $572.30 / $730.35
| Professional | | $509.40 | $572.30 | $730.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.65 / $594.88 / $594.88
| Professional | | $505.65 | $594.88 | $594.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.44 / $757.71 / $1,181.16
| Professional | | $553.44 | $757.71 | $1,181.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $664.77 / $879.27 / $880.56
| Professional | | $664.77 | $879.27 | $880.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.40 / $611.05 / $2,843.00
| Professional | | $509.40 | $611.05 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $991.00 / $1,415.10
| Professional | | $7.00 | $991.00 | $1,415.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.15 / $765.52 / $1,328.27
| Professional | | $579.15 | $765.52 | $1,328.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.36 / $557.89 / $954.37
| Facility | | $512.36 | $557.89 | $954.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.36 / $561.40 / $954.37
| Professional | | $512.36 | $561.40 | $954.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $3,742.00
| Facility | | $435.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.92 / $715.15 / $1,184.01
| Professional | | $550.92 | $715.15 | $1,184.01 |