- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,505.00 / $7,629.00
| Facility | | $540.00 | $2,505.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.20 / $215.79 / $486.27
| Professional | | $193.20 | $215.79 | $486.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.71 / $210.36 / $314.38
| Professional | | $202.71 | $210.36 | $314.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.27 / $264.14 / $427.51
| Professional | | $199.27 | $264.14 | $427.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.25 / $324.05 / $329.83
| Professional | | $244.25 | $324.05 | $329.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $0.50 / $11,023.78
| Facility | | $0.50 | $0.50 | $11,023.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,371.00 / $8,017.00
| Facility | | $617.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.35 / $239.65 / $868.00
| Professional | | $197.35 | $239.65 | $868.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $183.80 / $556.60
| Professional | | $5.00 | $183.80 | $556.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.01 / $269.22 / $428.03
| Professional | | $206.01 | $269.22 | $428.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.93 / $203.50 / $203.50
| Facility | | $202.93 | $203.50 | $203.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.60 / $203.50 / $218.12
| Professional | | $199.60 | $203.50 | $218.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.76 / $241.92 / $402.16
| Professional | | $164.76 | $241.92 | $402.16 |