- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,747.00 / $8,017.00
| Facility | | $594.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.41 / $263.45 / $390.40
| Professional | | $231.41 | $263.45 | $390.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,404.00 / $4,354.00 / $8,639.91
| Facility | | $2,404.00 | $4,354.00 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.02 / $267.76 / $353.40
| Professional | | $258.02 | $267.76 | $353.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.49 / $293.49 / $293.49
| Facility | | $293.49 | $293.49 | $293.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.93 / $317.98 / $521.80
| Professional | | $243.93 | $317.98 | $521.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.19 / $413.04 / $530.59
| Professional | | $307.19 | $413.04 | $530.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,679.00 / $8,017.00
| Facility | | $657.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.47 / $295.39 / $1,539.00
| Professional | | $236.47 | $295.39 | $1,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.50 / $379.50 / $558.10
| Professional | | $379.50 | $379.50 | $558.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.49 / $293.49 / $293.49
| Facility | | $293.49 | $293.49 | $293.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.98 / $321.62 / $544.62
| Professional | | $243.98 | $321.62 | $544.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.53 / $251.53 / $375.93
| Facility | | $251.53 | $251.53 | $375.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.66 / $251.53 / $375.93
| Professional | | $245.66 | $251.53 | $375.93 |
- 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
- $227.31 / $310.52 / $515.53
| Professional | | $227.31 | $310.52 | $515.53 |