- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.95 / $308.67 / $463.51
| Professional | | $262.95 | $308.67 | $463.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $5,951.00 / $8,887.00
| Facility | | $2,800.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.51 / $419.77 / $564.91
| Professional | | $263.51 | $419.77 | $564.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.18 / $387.06 / $607.50
| Professional | | $288.18 | $387.06 | $607.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.63 / $461.29 / $463.65
| Professional | | $348.63 | $461.29 | $463.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,459.37 / $15,459.37 / $39,479.75
| Facility | | $15,459.37 | $15,459.37 | $39,479.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $4,070.00 / $8,017.00
| Facility | | $954.00 | $4,070.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.05 / $330.15 / $1,068.00
| Professional | | $273.05 | $330.15 | $1,068.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $387.30 / $742.80
| Professional | | $4.00 | $387.30 | $742.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.56 / $389.47 / $637.28
| Professional | | $296.56 | $389.47 | $637.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.42 / $290.42 / $334.05
| Facility | | $290.42 | $290.42 | $334.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.74 / $291.70 / $334.05
| Professional | | $281.74 | $291.70 | $334.05 |
- 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
- $290.93 / $369.91 / $607.40
| Professional | | $290.93 | $369.91 | $607.40 |