- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.42 / $4,691.00 / $8,294.00
| Facility | | $397.42 | $4,691.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.38 / $403.33 / $607.63
| Professional | | $317.38 | $403.33 | $607.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.83 / $425.47 / $598.11
| Professional | | $336.83 | $425.47 | $598.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.68 / $765.73 / $3,472.00
| Professional | | $392.68 | $765.73 | $3,472.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.16 / $608.16 / $608.16
| Facility | | $608.16 | $608.16 | $608.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.99 / $507.42 / $868.41
| Professional | | $342.99 | $507.42 | $868.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.56 / $514.78 / $653.54
| Professional | | $437.56 | $514.78 | $653.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.59 / $503.72 / $780.53
| Facility | | $349.59 | $503.72 | $780.53 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $588.00 / $799.38 / $1,926.72
| Facility | 50 | $588.00 | $799.38 | $1,926.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.00 / $631.00 / $861.24
| Professional | | $556.00 | $631.00 | $861.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.85 / $454.18 / $7,420.00
| Facility | | $324.85 | $454.18 | $7,420.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.59 / $567.46 / $7,420.00
| Professional | | $441.59 | $567.46 | $7,420.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,349.00 / $6,870.00 / $12,739.00
| Facility | | $4,349.00 | $6,870.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.33 / $456.01 / $736.17
| Professional | | $323.33 | $456.01 | $736.17 |