- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.26 / $2,747.00 / $8,017.00
| Facility | | $512.26 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.82 / $450.80 / $884.58
| Professional | | $301.82 | $450.80 | $884.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.63 / $549.62 / $549.62
| Professional | | $529.63 | $549.62 | $549.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.03 / $490.81 / $825.89
| Professional | | $332.03 | $490.81 | $825.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.25 / $827.04 / $855.36
| Professional | | $643.25 | $827.04 | $855.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.92 / $523.92 / $523.92
| Professional | | $523.92 | $523.92 | $523.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.77 / $483.07 / $2,007.17
| Professional | | $305.77 | $483.07 | $2,007.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.28 / $471.19 / $819.34
| Professional | | $346.28 | $471.19 | $819.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.76 / $595.76 / $595.76
| Facility | | $595.76 | $595.76 | $595.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.49 / $520.73 / $856.64
| Professional | | $344.49 | $520.73 | $856.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.43 / $341.61 / $525.62
| Facility | | $234.43 | $341.61 | $525.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.29 / $366.05 / $564.47
| Professional | | $331.29 | $366.05 | $564.47 |
- 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
- $438.33 / $563.15 / $923.40
| Professional | | $438.33 | $563.15 | $923.40 |