- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.95 / $452.51 / $763.48
| Professional | | $373.95 | $452.51 | $763.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,824.00 / $4,354.00 / $8,459.92
| Facility | | $1,824.00 | $4,354.00 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.55 / $586.72 / $792.27
| Professional | | $402.55 | $586.72 | $792.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.95 / $564.63 / $884.15
| Professional | | $399.95 | $564.63 | $884.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.07 / $729.68 / $743.50
| Professional | | $550.07 | $729.68 | $743.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,498.05 / $7,498.05 / $7,949.90
| Facility | | $7,498.05 | $7,498.05 | $7,949.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.66 / $488.51 / $1,518.05
| Professional | | $403.66 | $488.51 | $1,518.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $407.40 / $1,252.90
| Professional | | $5.00 | $407.40 | $1,252.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.77 / $570.66 / $957.54
| Professional | | $430.77 | $570.66 | $957.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.61 / $458.44 / $458.44
| Facility | | $326.61 | $458.44 | $458.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.61 / $458.44 / $491.67
| Professional | | $326.61 | $458.44 | $491.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.85 / $548.76 / $910.54
| Professional | | $360.85 | $548.76 | $910.54 |