- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.01 / $595.67 / $2,590.35
| Facility | | $397.01 | $595.67 | $2,590.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.50 / $475.00 / $600.00
| Professional | | $370.50 | $475.00 | $600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.76 / $973.11 / $2,647.01
| Facility | | $261.76 | $973.11 | $2,647.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.23 / $666.00 / $2,369.29
| Professional | | $460.23 | $666.00 | $2,369.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.22 / $583.22 / $1,047.16
| Facility | | $366.22 | $583.22 | $1,047.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.89 / $133.82 / $180.72
| Professional | | $96.89 | $133.82 | $180.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.79 / $1,980.39 / $2,336.35
| Facility | | $274.79 | $1,980.39 | $2,336.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.20 / $696.57 / $1,405.45
| Professional | | $503.20 | $696.57 | $1,405.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.73 / $632.08 / $6,679.00
| Facility | | $285.73 | $632.08 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.73 / $420.90 / $761.66
| Professional | | $182.73 | $420.90 | $761.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.13 / $1,005.02 / $1,331.43
| Professional | | $509.13 | $1,005.02 | $1,331.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.64 / $783.50 / $2,509.19
| Facility | | $742.64 | $783.50 | $2,509.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.94 / $470.25 / $1,173.84
| Professional | | $199.94 | $470.25 | $1,173.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.60 / $2,647.01 / $2,647.01
| Facility | | $836.60 | $2,647.01 | $2,647.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.61 / $666.00 / $2,369.29
| Professional | | $465.61 | $666.00 | $2,369.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.61 / $638.25 / $1,292.17
| Professional | | $465.61 | $638.25 | $1,292.17 |