- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.00 / $2,244.00 / $7,542.00
| Facility | | $569.00 | $2,244.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.29 / $592.48 / $901.25
| Professional | | $513.29 | $592.48 | $901.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.67 / $626.30 / $18,738.00
| Facility | | $299.67 | $626.30 | $18,738.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.28 / $233.28 / $233.28
| Professional | | $233.28 | $233.28 | $233.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.24 / $3,603.00 / $6,702.00
| Facility | | $683.24 | $3,603.00 | $6,702.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $606.51 / $806.42 / $1,193.39
| Professional | | $606.51 | $806.42 | $1,193.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,897.00 / $5,897.00 / $9,651.74
| Facility | | $5,897.00 | $5,897.00 | $9,651.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,334.47 / $4,441.28 / $5,192.93
| Professional | | $4,334.47 | $4,441.28 | $5,192.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.86 / $686.45 / $1,069.29
| Facility | | $541.86 | $686.45 | $1,069.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.86 / $574.27 / $6,634.00
| Professional | | $541.86 | $574.27 | $6,634.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $784.48 / $1,031.03 / $1,325.91
| Professional | | $784.48 | $1,031.03 | $1,325.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.14 / $711.31 / $1,107.58
| Facility | | $547.14 | $711.31 | $1,107.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $593.27 / $809.06 / $1,226.19
| Professional | | $593.27 | $809.06 | $1,226.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,922.00 / $11,238.00
| Facility | | $1,634.00 | $4,922.00 | $11,238.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.60 / $317.79 / $523.91
| Professional | | $237.60 | $317.79 | $523.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.86 / $611.02 / $743.97
| Professional | | $541.86 | $611.02 | $743.97 |