- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,817.98 / $4,648.00 / $9,868.00
| Facility | | $1,817.98 | $4,648.00 | $9,868.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.25 / $253.25 / $911.06
| Professional | | $253.25 | $253.25 | $911.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $5,160.00 / $11,809.00
| Facility | | $3,283.00 | $5,160.00 | $11,809.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.25 / $47.50 / $100.56
| Professional | | $38.25 | $47.50 | $100.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.04 / $435.04 / $7,227.90
| Facility | | $435.04 | $435.04 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.70 / $590.66 / $1,630.75
| Professional | | $225.70 | $590.66 | $1,630.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $802.59 / $1,691.48
| Facility | | $319.00 | $802.59 | $1,691.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $763.83 / $917.16 / $1,339.71
| Professional | | $763.83 | $917.16 | $1,339.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.04 / $823.90 / $1,200.79
| Professional | | $540.04 | $823.90 | $1,200.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.04 / $555.00 / $7,227.90
| Facility | | $435.04 | $555.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.68 / $825.76 / $1,630.75
| Professional | | $283.68 | $825.76 | $1,630.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $4,840.00 / $9,202.00
| Facility | | $2,031.00 | $4,840.00 | $9,202.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.55 / $796.49 / $2,040.74
| Professional | | $529.55 | $796.49 | $2,040.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $857.71 / $857.71 / $857.71
| Facility | | $857.71 | $857.71 | $857.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.04 / $810.80 / $1,332.85
| Professional | | $540.04 | $810.80 | $1,332.85 |