- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $2,070.00 / $7,197.00
| Facility | | $480.00 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.36 / $357.12 / $575.03
| Professional | | $309.36 | $357.12 | $575.03 |
- 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
- $386.60 / $401.19 / $661.71
| Professional | | $386.60 | $401.19 | $661.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.02 / $584.02 / $584.02
| Facility | | $584.02 | $584.02 | $584.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.89 / $418.52 / $694.80
| Professional | | $298.89 | $418.52 | $694.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.57 / $626.37 / $802.45
| Professional | | $464.57 | $626.37 | $802.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.04 / $2,266.00 / $7,799.00
| Facility | | $607.04 | $2,266.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.75 / $385.95 / $1,541.00
| Professional | | $315.75 | $385.95 | $1,541.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.84 / $426.30 / $781.20
| Professional | | $397.84 | $426.30 | $781.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.02 / $584.02 / $584.02
| Facility | | $584.02 | $584.02 | $584.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.56 / $423.40 / $700.22
| Professional | | $310.56 | $423.40 | $700.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.81 / $335.14 / $373.08
| Facility | | $314.81 | $335.14 | $373.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.99 / $364.76 / $400.65
| Professional | | $326.99 | $364.76 | $400.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $2,391.00 / $4,789.00
| Facility | | $912.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.27 / $423.53 / $702.11
| Professional | | $326.27 | $423.53 | $702.11 |