- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,326.00 / $8,017.00
| Facility | | $617.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.52 / $348.64 / $432.98
| Professional | | $282.52 | $348.64 | $432.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.35 / $327.25 / $327.25
| Professional | | $315.35 | $327.25 | $327.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.30 / $392.76 / $640.65
| Professional | | $304.30 | $392.76 | $640.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.06 / $500.06 / $512.62
| Professional | | $500.06 | $500.06 | $512.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,442.87 / $7,687.13 / $12,810.95
| Facility | | $4,442.87 | $7,687.13 | $12,810.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,422.00 / $8,017.00
| Facility | | $641.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.86 / $411.85 / $1,613.22
| Professional | | $286.86 | $411.85 | $1,613.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $381.80 / $808.30
| Professional | | $15.00 | $381.80 | $808.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.30 / $396.33 / $635.54
| Professional | | $304.30 | $396.33 | $635.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.36 / $306.54 / $306.54
| Facility | | $250.36 | $306.54 | $306.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.36 / $306.54 / $325.77
| Professional | | $250.36 | $306.54 | $325.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.00 / $3,475.00 / $6,000.00
| Facility | | $1,440.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.51 / $360.15 / $615.32
| Professional | | $272.51 | $360.15 | $615.32 |