- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.74 / $157.38 / $251.79
| Professional | | $151.74 | $157.38 | $251.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.58 / $181.17 / $181.17
| Professional | | $174.58 | $181.17 | $181.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.70 / $222.34 / $476.36
| Professional | | $164.70 | $222.34 | $476.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.76 / $265.83 / $276.45
| Professional | | $206.76 | $265.83 | $276.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.91 / $181.29 / $1,659.00
| Professional | | $151.91 | $181.29 | $1,659.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.16 / $540.00 / $540.00
| Professional | | $177.16 | $540.00 | $540.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.30 / $200.30 / $200.30
| Facility | | $200.30 | $200.30 | $200.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.56 / $222.34 / $497.00
| Professional | | $168.56 | $222.34 | $497.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.65 / $170.65 / $337.76
| Facility | | $170.65 | $170.65 | $337.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.65 / $174.07 / $337.76
| Professional | | $170.65 | $174.07 | $337.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.54 / $215.52 / $364.83
| Professional | | $162.54 | $215.52 | $364.83 |