- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,371.00 / $8,017.00
| Facility | | $594.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.00 / $483.32 / $703.27
| Professional | | $406.00 | $483.32 | $703.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.80 / $476.23 / $476.23
| Professional | | $404.80 | $476.23 | $476.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.37 / $592.96 / $926.56
| Professional | | $443.37 | $592.96 | $926.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.41 / $709.69 / $714.94
| Professional | | $536.41 | $709.69 | $714.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,152.49 / $6,834.74 / $9,264.90
| Facility | | $5,152.49 | $6,834.74 | $9,264.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,371.00 / $8,017.00
| Facility | | $641.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.00 / $492.31 / $2,355.00
| Professional | | $406.00 | $492.31 | $2,355.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $557.90 / $1,145.70
| Professional | | $3.00 | $557.90 | $1,145.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.29 / $599.21 / $937.70
| Professional | | $444.29 | $599.21 | $937.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.85 / $444.85 / $465.47
| Facility | | $444.85 | $444.85 | $465.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.14 / $446.22 / $466.86
| Professional | | $432.14 | $446.22 | $466.86 |
- 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
- $444.59 / $563.58 / $917.52
| Professional | | $444.59 | $563.58 | $917.52 |