- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.98 / $1,758.00 / $3,693.00
| Facility | | $358.98 | $1,758.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.99 / $320.58 / $769.95
| Professional | | $195.99 | $320.58 | $769.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.84 / $2,376.00 / $8,498.00
| Facility | | $604.84 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.28 / $484.00 / $1,800.00
| Professional | | $243.28 | $484.00 | $1,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.39 / $382.72 / $675.35
| Facility | | $294.39 | $382.72 | $675.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.65 / $535.77 / $764.79
| Professional | | $375.65 | $535.77 | $764.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.80 / $450.29 / $931.54
| Professional | | $272.80 | $450.29 | $931.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.59 / $536.82 / $6,679.00
| Facility | | $253.59 | $536.82 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.99 / $445.40 / $614.82
| Professional | | $353.99 | $445.40 | $614.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.25 / $643.49 / $983.41
| Professional | | $309.25 | $643.49 | $983.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,724.47 / $3,217.80 / $4,784.74
| Facility | | $1,724.47 | $3,217.80 | $4,784.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.50 / $454.68 / $517.41
| Professional | | $294.50 | $454.68 | $517.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,253.29 / $3,372.00 / $16,394.00
| Facility | | $1,253.29 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.44 / $593.62 / $2,298.64
| Professional | | $293.44 | $593.62 | $2,298.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.96 / $442.64 / $861.34
| Professional | | $253.96 | $442.64 | $861.34 |