- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,663.12 / $4,806.64
| Facility | | $699.00 | $2,663.12 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.41 / $332.33 / $900.79
| Professional | | $173.41 | $332.33 | $900.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.28 / $2,600.00 / $4,952.00
| Facility | | $400.28 | $2,600.00 | $4,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.59 / $533.95 / $1,935.91
| Professional | | $182.59 | $533.95 | $1,935.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.93 / $249.51 / $489.42
| Facility | | $191.93 | $249.51 | $489.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.52 / $565.36 / $1,375.69
| Professional | | $244.52 | $565.36 | $1,375.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.67 / $568.40 / $1,118.68
| Professional | | $249.67 | $568.40 | $1,118.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.12 / $349.96 / $6,679.00
| Facility | | $168.12 | $349.96 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.15 / $422.66 / $681.41
| Professional | | $232.15 | $422.66 | $681.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.60 / $457.26 / $997.56
| Professional | | $211.60 | $457.26 | $997.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.72 / $1,326.08 / $4,436.96
| Facility | | $896.72 | $1,326.08 | $4,436.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.48 / $493.13 / $808.31
| Professional | | $261.48 | $493.13 | $808.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.33 / $2,600.00 / $8,498.00
| Facility | | $817.33 | $2,600.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.02 / $853.62 / $2,634.40
| Professional | | $424.02 | $853.62 | $2,634.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.75 / $553.29 / $1,263.84
| Professional | | $420.75 | $553.29 | $1,263.84 |