- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,747.00 / $8,017.00
| Facility | | $657.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.78 / $424.42 / $539.13
| Professional | | $376.78 | $424.42 | $539.13 |
- 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
- $426.41 / $442.50 / $442.50
| Professional | | $426.41 | $442.50 | $442.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.51 / $549.75 / $860.45
| Professional | | $411.51 | $549.75 | $860.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.14 / $660.48 / $665.46
| Professional | | $499.14 | $660.48 | $665.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,077.00 / $8,017.00
| Facility | | $832.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.78 / $456.49 / $2,239.61
| Professional | | $376.78 | $456.49 | $2,239.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $542.29 / $1,065.40
| Professional | | $3.00 | $542.29 | $1,065.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.19 / $556.15 / $867.42
| Professional | | $417.19 | $556.15 | $867.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.36 / $413.36 / $455.75
| Facility | | $413.36 | $413.36 | $455.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.66 / $414.51 / $455.75
| Professional | | $401.66 | $414.51 | $455.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.00 / $3,331.00 / $6,000.00
| Facility | | $1,447.00 | $3,331.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.52 / $521.76 / $855.30
| Professional | | $407.52 | $521.76 | $855.30 |