- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,128.00 / $7,542.00
| Facility | | $500.00 | $2,128.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.62 / $548.08 / $884.79
| Professional | | $163.62 | $548.08 | $884.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.00 / $12,723.00 / $19,343.00
| Facility | | $1,845.00 | $12,723.00 | $19,343.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.01 / $470.02 / $722.50
| Professional | | $155.01 | $470.02 | $722.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.82 / $149.82 / $149.82
| Facility | | $149.82 | $149.82 | $149.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.62 / $407.21 / $1,323.06
| Professional | | $195.62 | $407.21 | $1,323.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $1,086.28
| Facility | | $55.00 | $55.00 | $1,086.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,203.13 / $4,153.20 / $4,913.93
| Professional | | $2,203.13 | $4,153.20 | $4,913.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.66 / $480.33 / $926.25
| Facility | | $174.66 | $480.33 | $926.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.03 / $288.12 / $985.51
| Professional | | $214.03 | $288.12 | $985.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.44 / $572.45 / $1,005.13
| Professional | | $171.44 | $572.45 | $1,005.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.66 / $538.17 / $1,043.21
| Facility | | $174.66 | $538.17 | $1,043.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.26 / $483.93 / $1,375.88
| Professional | | $196.26 | $483.93 | $1,375.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.78 / $860.36 / $1,324.07
| Professional | | $629.78 | $860.36 | $1,324.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.63 / $538.17 / $762.62
| Professional | | $480.63 | $538.17 | $762.62 |