- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,422.00 / $7,799.00
| Facility | | $594.00 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.44 / $424.70 / $535.58
| Professional | | $371.44 | $424.70 | $535.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.73 / $593.03 / $787.66
| Professional | | $373.73 | $593.03 | $787.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.43 / $546.73 / $852.58
| Professional | | $416.43 | $546.73 | $852.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.04 / $656.38 / $661.49
| Professional | | $496.04 | $656.38 | $661.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,371.00 / $8,017.00
| Facility | | $641.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.44 / $454.40 / $2,226.61
| Professional | | $371.44 | $454.40 | $2,226.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $581.60 / $1,059.00
| Professional | | $6.00 | $581.60 | $1,059.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.45 / $552.58 / $854.91
| Professional | | $422.45 | $552.58 | $854.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.68 / $410.68 / $459.78
| Facility | | $410.68 | $410.68 | $459.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.10 / $411.77 / $459.78
| Professional | | $399.10 | $411.77 | $459.78 |
- 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
- $392.14 / $534.33 / $904.04
| Professional | | $392.14 | $534.33 | $904.04 |