- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,422.00 / $7,799.00
| Facility | | $594.00 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.68 / $214.67 / $298.77
| Professional | | $183.68 | $214.67 | $298.77 |
- 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
- $185.44 / $294.70 / $392.86
| Professional | | $185.44 | $294.70 | $392.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.56 / $272.82 / $425.43
| Professional | | $207.56 | $272.82 | $425.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.23 / $325.91 / $327.96
| Professional | | $246.23 | $325.91 | $327.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,867.33 / $6,867.33 / $7,721.60
| Facility | | $6,867.33 | $6,867.33 | $7,721.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,398.00 / $8,017.00
| Facility | | $641.00 | $2,398.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.45 / $232.31 / $1,109.09
| Professional | | $191.45 | $232.31 | $1,109.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $281.60 / $523.79
| Professional | | $3.00 | $281.60 | $523.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.17 / $273.36 / $465.64
| Professional | | $214.17 | $273.36 | $465.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.90 / $203.90 / $228.91
| Facility | | $203.90 | $203.90 | $228.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.09 / $204.51 / $228.91
| Professional | | $198.09 | $204.51 | $228.91 |
- 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
- $208.70 / $261.20 / $426.99
| Professional | | $208.70 | $261.20 | $426.99 |