- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $3,077.00 / $8,427.00
| Facility | | $594.00 | $3,077.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.94 / $218.97 / $458.00
| Professional | | $194.94 | $218.97 | $458.00 |
- 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
- $189.31 / $298.70 / $400.41
| Professional | | $189.31 | $298.70 | $400.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.39 / $277.98 / $434.51
| Professional | | $210.39 | $277.98 | $434.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.87 / $335.30 / $335.41
| Professional | | $252.87 | $335.30 | $335.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,072.74 / $5,587.84 / $9,532.37
| Facility | | $3,072.74 | $5,587.84 | $9,532.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,389.00 / $8,017.00
| Facility | | $918.00 | $3,389.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.95 / $271.31 / $897.00
| Professional | | $194.95 | $271.31 | $897.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $443.50 / $534.60
| Professional | | $3.00 | $443.50 | $534.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.14 / $278.68 / $465.32
| Professional | | $214.14 | $278.68 | $465.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.66 / $206.66 / $437.94
| Facility | | $206.66 | $206.66 | $437.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.74 / $207.30 / $437.94
| Professional | | $200.74 | $207.30 | $437.94 |
- 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
- $212.38 / $265.52 / $428.95
| Professional | | $212.38 | $265.52 | $428.95 |