- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.00 / $2,450.00 / $8,113.00
| Facility | | $316.00 | $2,450.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.59 / $322.75 / $522.20
| Professional | | $210.59 | $322.75 | $522.20 |
- 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
- $336.04 / $348.72 / $547.41
| Professional | | $336.04 | $348.72 | $547.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.25 / $375.89 / $619.23
| Professional | | $240.25 | $375.89 | $619.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.62 / $535.92 / $540.98
| Professional | | $403.62 | $535.92 | $540.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,072.74 / $8,418.12 / $12,434.15
| Facility | | $3,072.74 | $8,418.12 | $12,434.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,543.00 / $8,247.00
| Facility | | $540.00 | $2,543.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.45 / $350.57 / $909.11
| Professional | | $225.45 | $350.57 | $909.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $391.70 / $896.90
| Professional | | $6.00 | $391.70 | $896.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.71 / $388.13 / $641.25
| Professional | | $246.71 | $388.13 | $641.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.22 / $258.79 / $377.86
| Facility | | $223.22 | $258.79 | $377.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.22 / $326.52 / $356.62
| Professional | | $223.22 | $326.52 | $356.62 |
- 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
- $289.79 / $418.04 / $664.53
| Professional | | $289.79 | $418.04 | $664.53 |