- 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
- $306.48 / $341.56 / $486.23
| Professional | | $306.48 | $341.56 | $486.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.34 / $359.41 / $607.34
| Professional | | $346.34 | $359.41 | $607.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $394.30 / $394.30 / $394.30
| Facility | | $394.30 | $394.30 | $394.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.66 / $403.98 / $689.25
| Professional | | $301.66 | $403.98 | $689.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.63 / $559.29 / $714.46
| Professional | | $413.63 | $559.29 | $714.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.48 / $376.53 / $1,782.59
| Professional | | $306.48 | $376.53 | $1,782.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.90 / $468.90 / $708.00
| Professional | | $468.90 | $468.90 | $708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $394.30 / $394.30 / $394.30
| Facility | | $394.30 | $394.30 | $394.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.97 / $418.06 / $689.25
| Professional | | $301.97 | $418.06 | $689.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.84 / $334.84 / $440.31
| Facility | | $334.84 | $334.84 | $440.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.25 / $334.84 / $440.31
| Professional | | $326.25 | $334.84 | $440.31 |
- 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
- $293.61 / $391.62 / $635.35
| Professional | | $293.61 | $391.62 | $635.35 |