- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.00 / $3,077.00 / $8,113.00
| Facility | | $574.00 | $3,077.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.28 / $157.00 / $405.99
| Professional | | $145.28 | $157.00 | $405.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.74 / $162.66 / $306.10
| Professional | | $156.74 | $162.66 | $306.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.82 / $208.57 / $362.26
| Professional | | $151.82 | $208.57 | $362.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.99 / $245.55 / $245.55
| Professional | | $184.99 | $245.55 | $245.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,655.79 / $5,366.70 / $7,729.64
| Facility | | $2,655.79 | $5,366.70 | $7,729.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.00 / $3,508.53 / $8,017.00
| Facility | | $760.00 | $3,508.53 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.00 / $185.29 / $729.00
| Professional | | $146.00 | $185.29 | $729.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $216.90 / $391.60
| Professional | | $6.00 | $216.90 | $391.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.63 / $212.43 / $372.00
| Professional | | $157.63 | $212.43 | $372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.83 / $152.83 / $206.63
| Facility | | $152.83 | $152.83 | $206.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.18 / $153.58 / $206.63
| Professional | | $148.18 | $153.58 | $206.63 |
- 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
- $136.82 / $191.56 / $310.77
| Professional | | $136.82 | $191.56 | $310.77 |