- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.32 / $5,091.00 / $14,112.00
| Facility | | $405.32 | $5,091.00 | $14,112.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.06 / $405.31 / $588.54
| Professional | | $313.06 | $405.31 | $588.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,525.00 / $11,065.00 / $12,418.00
| Facility | | $8,525.00 | $11,065.00 | $12,418.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.74 / $442.13 / $606.38
| Professional | | $345.74 | $442.13 | $606.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.97 / $593.47 / $4,716.00
| Professional | | $417.97 | $593.47 | $4,716.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.98 / $481.19 / $917.30
| Professional | | $361.98 | $481.19 | $917.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.15 / $423.78 / $522.66
| Professional | | $353.15 | $423.78 | $522.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.89 / $494.27 / $741.74
| Facility | | $346.89 | $494.27 | $741.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.00 / $511.00 / $874.39
| Professional | | $449.00 | $511.00 | $874.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.09 / $481.95 / $7,902.00
| Facility | | $372.09 | $481.95 | $7,902.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.09 / $481.95 / $7,902.00
| Professional | | $372.09 | $481.95 | $7,902.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,367.00 / $13,296.00 / $26,537.00
| Facility | | $8,367.00 | $13,296.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.49 / $531.78 / $810.94
| Professional | | $304.49 | $531.78 | $810.94 |