- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,371.00 / $7,799.00
| Facility | | $540.00 | $2,371.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.71 / $123.55 / $146.13
| Professional | | $111.71 | $123.55 | $146.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.56 / $165.36 / $165.36
| Professional | | $140.56 | $165.36 | $165.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.00 / $939.95 / $2,109.00
| Facility | | $491.00 | $939.95 | $2,109.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.68 / $155.65 / $283.13
| Professional | | $113.68 | $155.65 | $283.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.44 / $591.44 / $591.44
| Facility | | $591.44 | $591.44 | $591.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.48 / $381.34 / $611.16
| Professional | | $253.48 | $381.34 | $611.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,215.63 / $6,215.63 / $6,215.63
| Facility | | $6,215.63 | $6,215.63 | $6,215.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,326.00 / $7,799.00
| Facility | | $617.00 | $2,326.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.08 / $132.99 / $1,426.00
| Professional | | $114.08 | $132.99 | $1,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $203.00 / $222.30
| Professional | | $5.00 | $203.00 | $222.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.16 / $932.58 / $2,151.00
| Facility | | $138.16 | $932.58 | $2,151.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.61 / $155.65 / $286.16
| Professional | | $114.61 | $155.65 | $286.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.48 / $150.33 / $150.33
| Facility | | $50.48 | $150.33 | $150.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.48 / $50.48 / $153.34
| Professional | | $50.48 | $50.48 | $153.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.00 / $1,728.00 / $4,300.00
| Facility | | $550.00 | $1,728.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.37 / $142.15 / $244.58
| Professional | | $107.37 | $142.15 | $244.58 |