- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.61 / $193.62 / $281.08
| Professional | | $175.61 | $193.62 | $281.08 |
- 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
- $185.76 / $307.45 / $372.70
| Professional | | $185.76 | $307.45 | $372.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.78 / $263.48 / $427.95
| Professional | | $192.78 | $263.48 | $427.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.90 / $285.75 / $285.75
| Professional | | $215.90 | $285.75 | $285.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $722.57 / $722.57 / $722.57
| Facility | | $722.57 | $722.57 | $722.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.61 / $211.84 / $1,143.66
| Professional | | $175.61 | $211.84 | $1,143.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $201.70 / $490.30
| Professional | | $5.00 | $201.70 | $490.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.38 / $273.56 / $439.09
| Professional | | $209.38 | $273.56 | $439.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.67 / $187.70 / $187.70
| Facility | | $170.67 | $187.70 | $187.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.67 / $187.70 / $196.39
| Professional | | $170.67 | $187.70 | $196.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.12 / $247.99 / $418.33
| Professional | | $194.12 | $247.99 | $418.33 |