- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.00 / $2,780.36 / $7,367.93
| Facility | | $316.00 | $2,780.36 | $7,367.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.59 / $329.92 / $633.52
| Professional | | $132.59 | $329.92 | $633.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.89 / $254.89 / $638.09
| Professional | | $254.89 | $254.89 | $638.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $5,951.00 / $8,887.00
| Facility | | $2,800.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.69 / $356.66 / $356.66
| Professional | | $343.69 | $356.66 | $356.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.04 / $355.27 / $701.76
| Professional | | $150.04 | $355.27 | $701.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.28 / $551.66 / $568.14
| Professional | | $416.28 | $551.66 | $568.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,377.35 / $4,409.59 / $10,086.53
| Facility | | $2,377.35 | $4,409.59 | $10,086.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.62 / $2,842.00 / $7,374.16
| Facility | | $341.62 | $2,842.00 | $7,374.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.84 / $341.62 / $847.24
| Professional | | $138.84 | $341.62 | $847.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $352.40 / $1,040.40
| Professional | | $3.00 | $352.40 | $1,040.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.62 / $356.66 / $724.90
| Professional | | $151.62 | $356.66 | $724.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.87 / $299.05 / $745.63
| Facility | | $135.87 | $299.05 | $745.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.87 / $359.25 / $393.55
| Professional | | $135.87 | $359.25 | $393.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.31 / $490.23 / $797.53
| Professional | | $356.31 | $490.23 | $797.53 |