- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.84 / $2,747.00 / $8,017.00
| Facility | | $582.84 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.79 / $472.89 / $690.61
| Professional | | $338.79 | $472.89 | $690.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.46 / $524.54 / $895.51
| Professional | | $505.46 | $524.54 | $895.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.10 / $453.33 / $693.74
| Professional | | $290.10 | $453.33 | $693.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.35 / $621.35 / $801.24
| Professional | | $621.35 | $621.35 | $801.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,215.85 / $3,215.85 / $3,215.85
| Facility | | $3,215.85 | $3,215.85 | $3,215.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,077.00 / $8,017.00
| Facility | | $832.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.21 / $516.71 / $2,467.00
| Professional | | $342.21 | $516.71 | $2,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.60 / $365.60 / $365.60
| Professional | | $365.60 | $365.60 | $365.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.79 / $465.00 / $693.74
| Professional | | $302.79 | $465.00 | $693.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.85 / $338.67 / $507.18
| Facility | | $311.85 | $338.67 | $507.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.91 / $421.16 / $544.53
| Professional | | $331.91 | $421.16 | $544.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.80 / $580.47 / $951.12
| Professional | | $401.80 | $580.47 | $951.12 |