- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.00 / $2,070.00 / $7,197.00
| Facility | | $428.00 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.72 / $336.37 / $446.48
| Professional | | $227.72 | $336.37 | $446.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.60 / $413.64 / $689.98
| Professional | | $398.60 | $413.64 | $689.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.47 / $416.47 / $416.47
| Facility | | $416.47 | $416.47 | $416.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.92 / $380.70 / $685.32
| Professional | | $234.92 | $380.70 | $685.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.58 / $635.67 / $824.90
| Professional | | $477.58 | $635.67 | $824.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,326.00 / $8,017.00
| Facility | | $641.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.34 / $365.94 / $1,334.69
| Professional | | $236.34 | $365.94 | $1,334.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.10 / $346.10 / $840.20
| Professional | | $346.10 | $346.10 | $840.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.47 / $416.47 / $416.47
| Facility | | $416.47 | $416.47 | $416.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.66 / $392.62 / $689.11
| Professional | | $249.66 | $392.62 | $689.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.35 / $235.77 / $363.50
| Facility | | $203.35 | $235.77 | $363.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.15 / $306.62 / $389.94
| Professional | | $230.15 | $306.62 | $389.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.87 / $452.88 / $725.25
| Professional | | $332.87 | $452.88 | $725.25 |