- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,675.00 / $8,104.00
| Facility | | $594.00 | $2,675.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.75 / $534.28 / $826.58
| Professional | | $231.75 | $534.28 | $826.58 |
- 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
- $495.25 / $674.99 / $954.67
| Professional | | $495.25 | $674.99 | $954.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.08 / $512.73 / $1,349.38
| Professional | | $280.08 | $512.73 | $1,349.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.82 / $896.90 / $919.84
| Professional | | $676.82 | $896.90 | $919.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,440.53 / $6,440.53 / $6,440.53
| Facility | | $6,440.53 | $6,440.53 | $6,440.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,605.00 / $8,017.00
| Facility | | $657.00 | $2,605.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.50 / $544.97 / $1,263.22
| Professional | | $257.50 | $544.97 | $1,263.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $925.00 / $1,642.20
| Professional | | $5.00 | $925.00 | $1,642.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.93 / $516.92 / $1,349.38
| Professional | | $282.93 | $516.92 | $1,349.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.70 / $253.74 / $914.63
| Facility | | $253.70 | $253.74 | $914.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.70 / $573.25 / $626.74
| Professional | | $253.70 | $573.25 | $626.74 |
- 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
- $572.04 / $786.67 / $1,390.79
| Professional | | $572.04 | $786.67 | $1,390.79 |