- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.52 / $2,463.00 / $7,799.00
| Facility | | $303.52 | $2,463.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.33 / $426.45 / $783.85
| Professional | | $285.33 | $426.45 | $783.85 |
- 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
- $512.90 / $532.26 / $874.67
| Professional | | $512.90 | $532.26 | $874.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.45 / $463.95 / $792.71
| Professional | | $314.45 | $463.95 | $792.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.92 / $804.76 / $833.27
| Professional | | $625.92 | $804.76 | $833.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,072.74 / $3,594.77 / $19,748.80
| Facility | | $3,072.74 | $3,594.77 | $19,748.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,679.00 / $8,017.00
| Facility | | $594.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.75 / $466.69 / $1,705.85
| Professional | | $288.75 | $466.69 | $1,705.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.86 / $453.59 / $798.92
| Professional | | $334.86 | $453.59 | $798.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.74 / $563.74 / $563.74
| Facility | | $563.74 | $563.74 | $563.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.89 / $495.14 / $822.22
| Professional | | $319.89 | $495.14 | $822.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.98 / $323.77 / $511.90
| Facility | | $202.98 | $323.77 | $511.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.67 / $343.72 / $550.79
| Professional | | $313.67 | $343.72 | $550.79 |
- 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
- $393.50 / $534.57 / $980.72
| Professional | | $393.50 | $534.57 | $980.72 |