- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.23 / $355.44 / $567.57
| Professional | | $312.23 | $355.44 | $567.57 |
- 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
- $357.54 / $371.03 / $371.03
| Professional | | $357.54 | $371.03 | $371.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.13 / $459.71 / $702.89
| Professional | | $342.13 | $459.71 | $702.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.56 / $555.28 / $560.16
| Professional | | $419.56 | $555.28 | $560.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,046.66 / $8,046.66 / $8,046.66
| Facility | | $8,046.66 | $8,046.66 | $8,046.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.73 / $392.58 / $1,659.00
| Professional | | $324.73 | $392.58 | $1,659.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $385.90 / $892.50
| Professional | | $3.00 | $385.90 | $892.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.65 / $465.79 / $729.77
| Professional | | $344.65 | $465.79 | $729.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.30 / $345.30 / $369.26
| Facility | | $345.30 | $345.30 | $369.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.84 / $345.92 / $369.26
| Professional | | $335.84 | $345.92 | $369.26 |
- 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
- $313.75 / $413.80 / $698.18
| Professional | | $313.75 | $413.80 | $698.18 |