- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,868.00 / $8,118.48
| Facility | | $594.00 | $2,868.00 | $8,118.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.59 / $232.65 / $337.51
| Professional | | $146.59 | $232.65 | $337.51 |
- 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
- $244.62 / $253.85 / $394.14
| Professional | | $244.62 | $253.85 | $394.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.13 / $265.89 / $450.88
| Professional | | $168.13 | $265.89 | $450.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.08 / $390.25 / $395.84
| Professional | | $294.08 | $390.25 | $395.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,222.00 / $4,578.95 / $6,935.90
| Facility | | $1,222.00 | $4,578.95 | $6,935.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.26 / $3,654.00 / $8,118.48
| Facility | | $803.26 | $3,654.00 | $8,118.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.59 / $240.17 / $578.78
| Professional | | $146.59 | $240.17 | $578.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $258.70 / $659.40
| Professional | | $6.00 | $258.70 | $659.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.60 / $276.93 / $459.84
| Professional | | $172.60 | $276.93 | $459.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.50 / $156.36 / $243.71
| Facility | | $155.50 | $156.36 | $243.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.50 / $205.71 / $260.57
| Professional | | $155.50 | $205.71 | $260.57 |
- 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
- $206.54 / $300.00 / $496.26
| Professional | | $206.54 | $300.00 | $496.26 |