- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.51 / $2,240.00 / $7,629.00
| Facility | | $479.51 | $2,240.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.01 / $393.36 / $661.76
| Professional | | $308.01 | $393.36 | $661.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.05 / $439.01 / $704.68
| Professional | | $423.05 | $439.01 | $704.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.76 / $396.08 / $639.40
| Professional | | $275.76 | $396.08 | $639.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.73 / $517.73 / $667.63
| Professional | | $517.73 | $517.73 | $667.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.35 / $529.35 / $529.35
| Professional | | $529.35 | $529.35 | $529.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,371.00 / $8,017.00
| Facility | | $594.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.67 / $413.96 / $1,525.00
| Professional | | $313.67 | $413.96 | $1,525.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.90 / $350.90 / $350.90
| Professional | | $350.90 | $350.90 | $350.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.80 / $401.28 / $639.40
| Professional | | $285.80 | $401.28 | $639.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.51 / $325.43 / $419.96
| Facility | | $317.51 | $325.43 | $419.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.32 / $360.10 / $449.75
| Professional | | $319.32 | $360.10 | $449.75 |
- 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
- $314.23 / $446.36 / $759.90
| Professional | | $314.23 | $446.36 | $759.90 |