- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.39 / $3,226.00 / $8,294.00
| Facility | | $318.39 | $3,226.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.13 / $346.52 / $569.09
| Professional | | $221.13 | $346.52 | $569.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,735.00 / $2,390.00 / $2,954.00
| Facility | | $1,735.00 | $2,390.00 | $2,954.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.41 / $295.93 / $428.32
| Professional | | $231.41 | $295.93 | $428.32 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $347.12 / $443.89 / $639.04
| Professional | 50 | $347.12 | $443.89 | $639.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.91 / $577.94 / $2,764.00
| Professional | | $281.91 | $577.94 | $2,764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.80 / $421.80 / $421.80
| Facility | | $421.80 | $421.80 | $421.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.32 / $422.04 / $758.33
| Professional | | $246.32 | $422.04 | $758.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.61 / $474.83 / $600.15
| Professional | | $403.61 | $474.83 | $600.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.50 / $421.92 / $727.91
| Facility | | $261.50 | $421.92 | $727.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.00 / $597.00 / $795.00
| Professional | | $525.00 | $597.00 | $795.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.85 / $321.52 / $1,380.00
| Facility | | $239.85 | $321.52 | $1,380.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.13 / $564.08 / $1,578.00
| Professional | | $430.13 | $564.08 | $1,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.00 / $1,045.00 / $2,364.00
| Facility | | $296.00 | $1,045.00 | $2,364.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.68 / $413.13 / $687.35
| Professional | | $285.68 | $413.13 | $687.35 |