- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,066.00 / $7,799.00
| Facility | | $882.00 | $3,066.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.01 / $388.58 / $830.28
| Professional | | $347.01 | $388.58 | $830.28 |
- 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
- $392.71 / $407.53 / $593.69
| Professional | | $392.71 | $407.53 | $593.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.52 / $444.52 / $444.52
| Facility | | $444.52 | $444.52 | $444.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.47 / $474.60 / $774.96
| Professional | | $360.47 | $474.60 | $774.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.01 / $436.52 / $2,035.72
| Professional | | $347.01 | $436.52 | $2,035.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.90 / $447.90 / $801.40
| Professional | | $447.90 | $447.90 | $801.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.52 / $444.52 / $444.52
| Facility | | $444.52 | $444.52 | $444.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.80 / $485.43 / $783.19
| Professional | | $364.80 | $485.43 | $783.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.21 / $379.21 / $419.34
| Facility | | $379.21 | $379.21 | $419.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.92 / $382.69 / $419.34
| Professional | | $365.92 | $382.69 | $419.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.57 / $457.47 / $744.96
| Professional | | $346.57 | $457.47 | $744.96 |