- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.48 / $1,803.00 / $3,625.00
| Facility | | $349.48 | $1,803.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.09 / $305.82 / $501.57
| Professional | | $207.09 | $305.82 | $501.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.73 / $2,410.09 / $12,000.00
| Facility | | $539.73 | $2,410.09 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.68 / $576.62 / $2,393.52
| Professional | | $262.68 | $576.62 | $2,393.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.93 / $336.58 / $600.34
| Facility | | $261.93 | $336.58 | $600.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.54 / $666.34 / $1,620.25
| Professional | | $429.54 | $666.34 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,103.98
| Facility | | $443.00 | $500.00 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.91 / $470.22 / $964.87
| Professional | | $261.91 | $470.22 | $964.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.71 / $477.60 / $6,679.00
| Facility | | $223.71 | $477.60 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.57 / $500.11 / $722.38
| Professional | | $385.57 | $500.11 | $722.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.02 / $595.04 / $905.45
| Professional | | $318.02 | $595.04 | $905.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $12,000.00
| Facility | | $1,061.00 | $2,854.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.21 / $812.83 / $2,393.52
| Professional | | $354.21 | $812.83 | $2,393.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.46 / $500.55 / $1,087.82
| Professional | | $331.46 | $500.55 | $1,087.82 |