- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.00 / $3,627.00 / $8,017.00
| Facility | | $749.00 | $3,627.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.35 / $410.75 / $561.01
| Professional | | $345.35 | $410.75 | $561.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.35 / $382.25 / $382.25
| Professional | | $368.35 | $382.25 | $382.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.96 / $482.05 / $783.29
| Professional | | $359.96 | $482.05 | $783.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.85 / $568.85 / $592.20
| Professional | | $568.85 | $568.85 | $592.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,315.49 / $13,564.54 / $17,638.80
| Facility | | $7,315.49 | $13,564.54 | $17,638.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.82 / $380.82 / $415.34
| Professional | | $380.82 | $380.82 | $415.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,068.00 / $8,017.00
| Facility | | $832.00 | $4,068.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.00 / $446.34 / $1,749.00
| Professional | | $370.00 | $446.34 | $1,749.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $585.79 / $928.20
| Professional | | $6.00 | $585.79 | $928.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.67 / $492.57 / $783.29
| Professional | | $380.67 | $492.57 | $783.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.96 / $360.96 / $385.67
| Facility | | $360.96 | $360.96 | $385.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.38 / $366.32 / $385.67
| Professional | | $346.38 | $366.32 | $385.67 |
- 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
- $349.88 / $478.33 / $765.89
| Professional | | $349.88 | $478.33 | $765.89 |