- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,838.00 / $8,017.00
| Facility | | $768.00 | $3,838.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.30 / $278.11 / $323.98
| Professional | | $250.30 | $278.11 | $323.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.99 / $299.93 / $435.70
| Professional | | $205.99 | $299.93 | $435.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.62 / $319.31 / $498.73
| Professional | | $228.62 | $319.31 | $498.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.72 / $360.72 / $376.97
| Professional | | $360.72 | $360.72 | $376.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,029.11 / $7,029.11 / $11,568.17
| Facility | | $7,029.11 | $7,029.11 | $11,568.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $4,068.00 / $8,017.00
| Facility | | $954.00 | $4,068.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.71 / $294.16 / $3,494.00
| Professional | | $243.71 | $294.16 | $3,494.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $388.30 / $582.79
| Professional | | $3.00 | $388.30 | $582.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.92 / $323.43 / $498.73
| Professional | | $247.92 | $323.43 | $498.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.47 / $227.47 / $262.47
| Facility | | $227.47 | $227.47 | $262.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.07 / $231.06 / $262.47
| Professional | | $218.07 | $231.06 | $262.47 |
- 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
- $227.74 / $302.95 / $471.16
| Professional | | $227.74 | $302.95 | $471.16 |