- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $3,090.30 / $5,128.61
| Facility | | $302.00 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $338.84 / $870.96
| Professional | | $269.15 | $338.84 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,235.94 / $45,708.82
| Facility | | $660.69 | $3,235.94 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $457.09 / $1,096.48
| Professional | | $269.15 | $457.09 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $338.84 / $776.25
| Facility | | $338.84 | $338.84 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $575.44 / $870.96
| Professional | | $338.84 | $575.44 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $489.78 / $851.14
| Professional | | $302.00 | $489.78 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $575.44 / $7,079.46
| Facility | | $275.42 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $457.09 / $630.96
| Professional | | $363.08 | $457.09 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $537.03 / $851.14
| Professional | | $316.23 | $537.03 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $229.09 / $309.03
| Professional | | $204.17 | $229.09 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,235.94 / $45,708.82
| Facility | | $660.69 | $3,235.94 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $457.09 / $1,096.48
| Professional | | $269.15 | $457.09 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $9,120.11
| Facility | | $1,862.09 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $489.78 / $870.96
| Professional | | $302.00 | $489.78 | $870.96 |