- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.41 / $3,839.00 / $8,247.00
| Facility | | $478.41 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.24 / $447.87 / $627.49
| Professional | | $397.24 | $447.87 | $627.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.82 / $489.62 / $796.59
| Professional | | $471.82 | $489.62 | $796.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.05 / $600.90 / $981.74
| Professional | | $454.05 | $600.90 | $981.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.64 / $795.39 / $795.39
| Professional | | $589.64 | $795.39 | $795.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.26 / $492.16 / $2,344.92
| Professional | | $404.26 | $492.16 | $2,344.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $478.40 / $1,186.80
| Professional | | $9.00 | $478.40 | $1,186.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.87 / $600.90 / $981.74
| Professional | | $464.87 | $600.90 | $981.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.76 / $456.76 / $581.27
| Facility | | $456.76 | $456.76 | $581.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.33 / $464.04 / $581.27
| Professional | | $437.33 | $464.04 | $581.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.88 / $623.14 / $977.28
| Professional | | $453.88 | $623.14 | $977.28 |