- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.61 / $2,124.00 / $6,762.00
| Facility | | $489.61 | $2,124.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.01 / $446.57 / $647.37
| Professional | | $133.01 | $446.57 | $647.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $6,055.00 / $9,037.00
| Facility | | $2,400.00 | $6,055.00 | $9,037.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.62 / $229.02 / $603.15
| Professional | | $125.62 | $229.02 | $603.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.75 / $124.75 / $124.75
| Facility | | $124.75 | $124.75 | $124.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.33 / $369.61 / $905.00
| Professional | | $159.33 | $369.61 | $905.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $878.42
| Facility | | $55.00 | $55.00 | $878.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,783.69 / $3,407.60 / $3,985.73
| Professional | | $1,783.69 | $3,407.60 | $3,985.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.01 / $392.29 / $886.15
| Facility | | $133.01 | $392.29 | $886.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.82 / $505.25 / $803.81
| Professional | | $172.82 | $505.25 | $803.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.01 / $419.41 / $1,249.72
| Facility | | $133.01 | $419.41 | $1,249.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.27 / $409.68 / $943.94
| Professional | | $161.27 | $409.68 | $943.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.79 / $649.27 / $1,076.21
| Professional | | $481.79 | $649.27 | $1,076.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.02 / $439.54 / $622.76
| Professional | | $392.02 | $439.54 | $622.76 |