- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.16 / $3,938.00 / $9,038.00
| Facility | | $432.16 | $3,938.00 | $9,038.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.89 / $404.99 / $858.57
| Professional | | $294.89 | $404.99 | $858.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,697.00
| Facility | | $4,100.00 | $7,264.00 | $12,697.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.82 / $340.95 / $825.29
| Professional | | $260.82 | $340.95 | $825.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.71 / $476.71 / $37,499.62
| Facility | | $476.71 | $476.71 | $37,499.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.71 / $476.71 / $476.71
| Professional | | $476.71 | $476.71 | $476.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.91 / $384.91 / $7,227.90
| Facility | | $384.91 | $384.91 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.25 / $586.76 / $1,176.70
| Professional | | $333.25 | $586.76 | $1,176.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.00 / $523.00 / $881.87
| Facility | | $278.00 | $523.00 | $881.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.94 / $456.34 / $682.94
| Professional | | $391.94 | $456.34 | $682.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.25 / $378.84 / $620.74
| Professional | | $276.25 | $378.84 | $620.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.91 / $555.00 / $7,227.90
| Facility | | $384.91 | $555.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.86 / $610.64 / $1,211.79
| Professional | | $351.86 | $610.64 | $1,211.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,768.00 / $4,176.00 / $8,312.00
| Facility | | $1,768.00 | $4,176.00 | $8,312.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.46 / $465.42 / $956.05
| Professional | | $330.46 | $465.42 | $956.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.73 / $387.73 / $1,113.51
| Facility | | $387.73 | $387.73 | $1,113.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.16 / $409.14 / $716.62
| Professional | | $298.16 | $409.14 | $716.62 |