- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $2,747.00 / $8,017.00
| Facility | | $882.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.57 / $354.90 / $593.38
| Professional | | $316.57 | $354.90 | $593.38 |
- 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
- $356.46 / $369.91 / $626.79
| Professional | | $356.46 | $369.91 | $626.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.47 / $405.47 / $405.47
| Facility | | $405.47 | $405.47 | $405.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.89 / $427.07 / $716.31
| Professional | | $335.89 | $427.07 | $716.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.12 / $574.64 / $734.29
| Professional | | $425.12 | $574.64 | $734.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $2,679.00 / $8,017.00
| Facility | | $934.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.89 / $388.68 / $1,767.14
| Professional | | $323.89 | $388.68 | $1,767.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.30 / $471.30 / $729.70
| Professional | | $471.30 | $471.30 | $729.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.47 / $405.47 / $405.47
| Facility | | $405.47 | $405.47 | $405.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.28 / $434.70 / $716.31
| Professional | | $336.28 | $434.70 | $716.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.11 / $345.11 / $435.00
| Facility | | $345.11 | $345.11 | $435.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.02 / $345.22 / $435.00
| Professional | | $336.02 | $345.22 | $435.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.50 / $423.80 / $696.44
| Professional | | $314.50 | $423.80 | $696.44 |