- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.94 / $2,238.50 / $7,629.00
| Facility | | $469.94 | $2,238.50 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.24 / $350.18 / $505.33
| Professional | | $86.24 | $350.18 | $505.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.72 / $522.05 / $699.55
| Professional | | $310.72 | $522.05 | $699.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.81 / $220.00 / $668.49
| Professional | | $95.81 | $220.00 | $668.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.05 / $571.05 / $590.70
| Professional | | $571.05 | $571.05 | $590.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.92 / $432.92 / $432.92
| Facility | | $432.92 | $432.92 | $432.92 |
- 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
- $86.24 / $362.73 / $888.18
| Professional | | $86.24 | $362.73 | $888.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $474.10 / $1,046.80
| Professional | | $4.00 | $474.10 | $1,046.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.84 / $220.28 / $668.22
| Professional | | $95.84 | $220.28 | $668.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.18 / $103.57 / $446.80
| Facility | | $79.18 | $103.57 | $446.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.18 / $103.57 / $392.24
| Professional | | $79.18 | $103.57 | $392.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $3,742.00
| Facility | | $435.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.10 / $517.04 / $844.96
| Professional | | $399.10 | $517.04 | $844.96 |