- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,483.00 / $8,017.00
| Facility | | $594.00 | $2,483.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.22 / $419.40 / $578.65
| Professional | | $343.22 | $419.40 | $578.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.39 / $608.84 / $798.78
| Professional | | $334.39 | $608.84 | $798.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.52 / $536.96 / $788.00
| Professional | | $375.52 | $536.96 | $788.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $573.34 / $573.34 / $594.89
| Professional | | $573.34 | $573.34 | $594.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.48 / $411.64 / $441.27
| Professional | | $410.48 | $411.64 | $441.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,483.00 / $8,017.00
| Facility | | $641.00 | $2,483.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.22 / $455.35 / $1,342.38
| Professional | | $343.22 | $455.35 | $1,342.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $536.00 / $933.60
| Professional | | $6.00 | $536.00 | $933.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.66 / $540.82 / $850.88
| Professional | | $420.66 | $540.82 | $850.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.70 / $371.70 / $376.47
| Facility | | $371.70 | $371.70 | $376.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.41 / $376.47 / $386.74
| Professional | | $356.41 | $376.47 | $386.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,584.00 / $9,631.00
| Facility | | $2,304.00 | $4,584.00 | $9,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.95 / $513.76 / $786.07
| Professional | | $387.95 | $513.76 | $786.07 |