- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.00 / $2,221.00 / $7,316.00
| Facility | | $521.00 | $2,221.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.52 / $486.65 / $667.54
| Professional | | $418.52 | $486.65 | $667.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.72 / $428.24 / $493.89
| Professional | | $408.72 | $428.24 | $493.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.36 / $407.36 / $407.36
| Facility | | $407.36 | $407.36 | $407.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,376.10 / $2,376.10 / $2,376.10
| Facility | | $2,376.10 | $2,376.10 | $2,376.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.95 / $610.77 / $944.43
| Professional | | $465.95 | $610.77 | $944.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,388.90 / $12,000.00 / $12,000.00
| Facility | | $9,388.90 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,308.72 / $3,384.32 / $3,781.13
| Professional | | $3,308.72 | $3,384.32 | $3,781.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.41 / $601.05 / $998.58
| Facility | | $446.41 | $601.05 | $998.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $573.99 / $675.54 / $794.75
| Professional | | $573.99 | $675.54 | $794.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $705.60 / $705.60 / $705.60
| Professional | | $705.60 | $705.60 | $705.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.41 / $610.01 / $1,147.28
| Facility | | $446.41 | $610.01 | $1,147.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.95 / $620.35 / $1,019.93
| Professional | | $465.95 | $620.35 | $1,019.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.78 / $518.07 / $800.65
| Professional | | $376.78 | $518.07 | $800.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.83 / $430.67 / $596.36
| Professional | | $376.83 | $430.67 | $596.36 |