- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.00 / $3,174.00 / $10,836.00
| Facility | | $727.00 | $3,174.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.21 / $432.26 / $648.58
| Professional | | $375.21 | $432.26 | $648.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,223.31 / $3,947.00 / $7,494.30
| Facility | | $2,223.31 | $3,947.00 | $7,494.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.66 / $502.97 / $700.75
| Professional | | $394.66 | $502.97 | $700.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.49 / $372.49 / $372.49
| Facility | | $372.49 | $372.49 | $372.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,403.30 / $2,403.30 / $2,403.30
| Facility | | $2,403.30 | $2,403.30 | $2,403.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.51 / $569.29 / $873.77
| Professional | | $430.51 | $569.29 | $873.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $9,496.40
| Facility | | $55.00 | $55.00 | $9,496.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,827.26 / $3,827.26 / $3,827.26
| Professional | | $3,827.26 | $3,827.26 | $3,827.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.08 / $540.54 / $1,048.42
| Facility | | $411.08 | $540.54 | $1,048.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $542.45 / $667.63 / $751.09
| Professional | | $542.45 | $667.63 | $751.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $569.70 / $569.70 / $569.70
| Professional | | $569.70 | $569.70 | $569.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.08 / $540.90 / $1,128.44
| Facility | | $411.08 | $540.90 | $1,128.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.51 / $583.51 / $923.07
| Professional | | $430.51 | $583.51 | $923.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,293.00 / $7,600.00
| Facility | | $1,154.00 | $3,293.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.38 / $460.25 / $742.99
| Professional | | $339.38 | $460.25 | $742.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.13 / $405.36 / $562.29
| Professional | | $356.13 | $405.36 | $562.29 |