- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,142.00 / $7,799.00
| Facility | | $882.00 | $3,142.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.99 / $466.09 / $692.11
| Professional | | $415.99 | $466.09 | $692.11 |
- 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
- $473.31 / $491.17 / $491.17
| Professional | | $473.31 | $491.17 | $491.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.02 / $537.02 / $537.02
| Facility | | $537.02 | $537.02 | $537.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.99 / $561.25 / $923.19
| Professional | | $394.99 | $561.25 | $923.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.39 / $719.33 / $943.77
| Professional | | $546.39 | $719.33 | $943.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,017.00
| Facility | | $1,013.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.17 / $538.38 / $2,520.13
| Professional | | $421.17 | $538.38 | $2,520.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $632.90 / $632.90 / $999.50
| Professional | | $632.90 | $632.90 | $999.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.02 / $537.02 / $537.02
| Facility | | $537.02 | $537.02 | $537.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.39 / $575.78 / $923.88
| Professional | | $423.39 | $575.78 | $923.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.33 / $458.33 / $575.17
| Facility | | $458.33 | $458.33 | $575.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.76 / $458.33 / $575.17
| Professional | | $446.76 | $458.33 | $575.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $4,815.00
| Facility | | $1,175.00 | $2,715.00 | $4,815.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.92 / $600.76 / $938.06
| Professional | | $466.92 | $600.76 | $938.06 |