- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,104.00
| Facility | | $832.00 | $2,747.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.97 / $667.80 / $866.25
| Professional | | $527.97 | $667.80 | $866.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,800.00 / $11,479.00 / $17,952.00
| Facility | | $5,800.00 | $11,479.00 | $17,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $639.90 / $664.05 / $664.05
| Professional | | $639.90 | $664.05 | $664.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.13 / $796.26 / $1,314.69
| Professional | | $575.13 | $796.26 | $1,314.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $766.88 / $1,017.23 / $1,031.40
| Professional | | $766.88 | $1,017.23 | $1,031.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $0.50 / $15,773.29
| Facility | | $0.50 | $0.50 | $15,773.29 |
- 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
- $527.97 / $687.58 / $2,605.00
| Professional | | $527.97 | $687.58 | $2,605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $650.29 / $1,737.30
| Professional | | $5.00 | $650.29 | $1,737.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $618.23 / $796.92 / $1,344.29
| Professional | | $618.23 | $796.92 | $1,344.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.09 / $644.15 / $644.15
| Facility | | $524.09 | $644.15 | $644.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.09 / $644.15 / $687.73
| Professional | | $524.09 | $644.15 | $687.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.86 / $754.21 / $1,233.50
| Professional | | $499.86 | $754.21 | $1,233.50 |