- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.24 / $2,079.00 / $3,625.00
| Facility | | $330.24 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.41 / $384.02 / $524.32
| Professional | | $326.41 | $384.02 | $524.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $367.18 / $941.10 / $2,713.00
| Facility | | $367.18 | $941.10 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.14 / $492.03 / $2,352.64
| Professional | | $253.14 | $492.03 | $2,352.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.86 / $506.04 / $894.34
| Facility | | $389.86 | $506.04 | $894.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.39 / $658.75 / $866.07
| Professional | | $492.39 | $658.75 | $866.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $210.10
| Facility | | $50.00 | $50.00 | $210.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.92 / $588.95 / $1,051.61
| Professional | | $323.92 | $588.95 | $1,051.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.56 / $710.86 / $6,679.00
| Facility | | $325.56 | $710.86 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.95 / $462.56 / $638.51
| Professional | | $366.95 | $462.56 | $638.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.31 / $744.96 / $1,008.92
| Professional | | $397.31 | $744.96 | $1,008.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,818.00 / $3,445.00
| Facility | | $55.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.42 / $605.66 / $2,555.02
| Professional | | $331.42 | $605.66 | $2,555.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.00 / $1,790.00 / $2,796.00
| Facility | | $502.00 | $1,790.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.64 / $451.26 / $989.40
| Professional | | $319.64 | $451.26 | $989.40 |