- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,839.00 / $7,922.40
| Facility | | $768.00 | $3,839.00 | $7,922.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.51 / $264.89 / $337.14
| Professional | | $234.51 | $264.89 | $337.14 |
- 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
- $231.68 / $371.52 / $504.42
| Professional | | $231.68 | $371.52 | $504.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.76 / $347.32 / $541.38
| Professional | | $253.76 | $347.32 | $541.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.27 / $401.03 / $401.03
| Professional | | $303.27 | $401.03 | $401.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,013.18 / $6,013.18 / $6,013.18
| Facility | | $6,013.18 | $6,013.18 | $6,013.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.51 / $285.08 / $1,524.98
| Professional | | $234.51 | $285.08 | $1,524.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $291.39 / $646.60
| Professional | | $3.00 | $291.39 | $646.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.18 / $351.00 / $609.03
| Professional | | $260.18 | $351.00 | $609.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $388.50
| Facility | | $257.04 | $257.04 | $388.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.47 / $259.12 / $388.50
| Professional | | $248.47 | $259.12 | $388.50 |
- 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
- $261.20 / $329.27 / $546.13
| Professional | | $261.20 | $329.27 | $546.13 |