- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,422.00 / $8,017.00
| Facility | | $594.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.95 / $472.18 / $621.04
| Professional | | $425.95 | $472.18 | $621.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.61 / $671.03 / $946.48
| Professional | | $457.61 | $671.03 | $946.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.28 / $653.29 / $1,046.23
| Professional | | $497.28 | $653.29 | $1,046.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.34 / $853.10 / $853.10
| Professional | | $633.34 | $853.10 | $853.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,343.76 / $8,343.76 / $8,343.76
| Facility | | $8,343.76 | $8,343.76 | $8,343.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,422.00 / $8,017.00
| Facility | | $641.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.95 / $533.72 / $1,978.00
| Professional | | $425.95 | $533.72 | $1,978.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $923.00 / $1,279.50
| Professional | | $6.00 | $923.00 | $1,279.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.28 / $660.72 / $1,125.74
| Professional | | $497.28 | $660.72 | $1,125.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.40 / $509.27 / $509.27
| Facility | | $480.40 | $509.27 | $509.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.40 / $509.27 / $535.50
| Professional | | $480.40 | $509.27 | $535.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.84 / $575.99 / $1,049.10
| Professional | | $431.84 | $575.99 | $1,049.10 |