- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.17 / $2,070.00 / $7,799.00
| Facility | | $458.17 | $2,070.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.56 / $377.71 / $538.24
| Professional | | $309.56 | $377.71 | $538.24 |
- 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
- $376.78 / $541.29 / $789.98
| Professional | | $376.78 | $541.29 | $789.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.47 / $523.04 / $807.90
| Professional | | $374.47 | $523.04 | $807.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.78 / $664.19 / $670.13
| Professional | | $501.78 | $664.19 | $670.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,326.00 / $8,017.00
| Facility | | $594.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.37 / $419.67 / $1,541.00
| Professional | | $320.37 | $419.67 | $1,541.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $970.30 / $1,075.40
| Professional | | $6.00 | $970.30 | $1,075.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.59 / $524.03 / $828.96
| Professional | | $378.59 | $524.03 | $828.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.28 / $342.31 / $991.08
| Facility | | $339.28 | $342.31 | $991.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.28 / $402.10 / $435.07
| Professional | | $339.28 | $402.10 | $435.07 |
- 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
- $431.23 / $563.10 / $895.96
| Professional | | $431.23 | $563.10 | $895.96 |