- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.96 / $3,090.07 / $8,115.00
| Facility | | $519.96 | $3,090.07 | $8,115.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.77 / $421.26 / $728.90
| Professional | | $255.77 | $421.26 | $728.90 |
- 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
- $442.38 / $459.07 / $459.07
| Professional | | $442.38 | $459.07 | $459.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.64 / $469.97 / $828.89
| Professional | | $286.64 | $469.97 | $828.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.66 / $698.91 / $712.17
| Professional | | $527.66 | $698.91 | $712.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.80 / $5,802.77 / $9,182.08
| Facility | | $2,528.80 | $5,802.77 | $9,182.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $3,090.07 / $8,115.00
| Facility | | $652.00 | $3,090.07 | $8,115.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.72 / $465.33 / $982.72
| Professional | | $269.72 | $465.33 | $982.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $804.30 / $1,244.00
| Professional | | $3.00 | $804.30 | $1,244.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.39 / $481.17 / $828.89
| Professional | | $291.39 | $481.17 | $828.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.10 / $404.16 / $775.32
| Facility | | $265.10 | $404.16 | $775.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.10 / $446.02 / $486.04
| Professional | | $265.10 | $446.02 | $486.04 |
- 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
- $438.17 / $572.29 / $910.97
| Professional | | $438.17 | $572.29 | $910.97 |