- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.57 / $368.31 / $514.02
| Professional | | $321.57 | $368.31 | $514.02 |
- 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
- $354.82 / $390.01 / $668.44
| Professional | | $354.82 | $390.01 | $668.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.65 / $405.65 / $405.65
| Facility | | $405.65 | $405.65 | $405.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.24 / $457.42 / $752.54
| Professional | | $343.24 | $457.42 | $752.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.47 / $572.04 / $717.63
| Professional | | $415.47 | $572.04 | $717.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,077.00 / $8,017.00
| Facility | | $954.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.16 / $423.86 / $1,821.04
| Professional | | $330.16 | $423.86 | $1,821.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $636.10 / $636.10 / $757.00
| Professional | | $636.10 | $636.10 | $757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.65 / $405.65 / $405.65
| Facility | | $405.65 | $405.65 | $405.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.37 / $459.39 / $785.07
| Professional | | $344.37 | $459.39 | $785.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.79 / $346.79 / $536.13
| Facility | | $346.79 | $346.79 | $536.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.68 / $353.06 / $486.25
| Professional | | $331.68 | $353.06 | $486.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.00 / $4,789.00 / $22,992.86
| Facility | | $1,781.00 | $4,789.00 | $22,992.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.37 / $463.54 / $731.44
| Professional | | $351.37 | $463.54 | $731.44 |