- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.74 / $2,747.00 / $7,799.00
| Facility | | $607.74 | $2,747.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.59 / $472.07 / $657.48
| Professional | | $218.59 | $472.07 | $657.48 |
- 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
- $501.50 / $520.41 / $520.41
| Professional | | $501.50 | $520.41 | $520.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.81 / $487.94 / $976.68
| Professional | | $259.81 | $487.94 | $976.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.82 / $800.23 / $819.51
| Professional | | $603.82 | $800.23 | $819.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,430.30 / $5,430.30 / $6,751.09
| Facility | | $5,430.30 | $5,430.30 | $6,751.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,077.00 / $8,017.00
| Facility | | $832.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.68 / $488.24 / $1,130.40
| Professional | | $233.68 | $488.24 | $1,130.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $521.79 / $1,467.70
| Professional | | $3.00 | $521.79 | $1,467.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.72 / $487.94 / $976.68
| Professional | | $263.72 | $487.94 | $976.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.05 / $509.62 / $785.13
| Facility | | $239.05 | $509.62 | $785.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.05 / $513.17 / $560.46
| Professional | | $239.05 | $513.17 | $560.46 |
- 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
- $488.84 / $654.40 / $1,075.24
| Professional | | $488.84 | $654.40 | $1,075.24 |