- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,371.00 / $7,799.00
| Facility | | $594.00 | $2,371.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.78 / $524.99 / $670.15
| Professional | | $467.78 | $524.99 | $670.15 |
- 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
- $464.02 / $739.25 / $1,004.62
| Professional | | $464.02 | $739.25 | $1,004.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.46 / $693.28 / $1,082.33
| Professional | | $507.46 | $693.28 | $1,082.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $608.86 / $805.40 / $805.40
| Professional | | $608.86 | $805.40 | $805.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,371.00 / $8,017.00
| Facility | | $641.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.78 / $559.89 / $2,782.87
| Professional | | $467.78 | $559.89 | $2,782.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $710.90 / $1,293.30
| Professional | | $7.00 | $710.90 | $1,293.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.67 / $701.73 / $1,217.57
| Professional | | $530.67 | $701.73 | $1,217.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.46 / $511.46 / $775.09
| Facility | | $511.46 | $511.46 | $775.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $494.89 / $515.10 / $775.09
| Professional | | $494.89 | $515.10 | $775.09 |
- 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
- $522.16 / $667.78 / $1,119.94
| Professional | | $522.16 | $667.78 | $1,119.94 |