- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.00 / $2,747.00 / $8,017.00
| Facility | | $760.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.21 / $278.08 / $390.73
| Professional | | $232.21 | $278.08 | $390.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.44 / $361.68 / $495.29
| Professional | | $226.44 | $361.68 | $495.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.29 / $362.96 / $853.98
| Professional | | $254.29 | $362.96 | $853.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.45 / $392.10 / $392.10
| Professional | | $296.45 | $392.10 | $392.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,120.00 / $8,017.00
| Facility | | $832.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.73 / $280.11 / $1,056.00
| Professional | | $233.73 | $280.11 | $1,056.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $357.90 / $640.20
| Professional | | $3.00 | $357.90 | $640.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.77 / $366.60 / $853.98
| Professional | | $261.77 | $366.60 | $853.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.23 / $250.23 / $391.05
| Facility | | $250.23 | $250.23 | $391.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.00 / $252.16 / $391.05
| Professional | | $242.00 | $252.16 | $391.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $6,368.00 / $16,362.19
| Facility | | $2,468.00 | $6,368.00 | $16,362.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.35 / $349.65 / $855.54
| Professional | | $258.35 | $349.65 | $855.54 |