- 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
- $258.99 / $294.05 / $396.31
| Professional | | $258.99 | $294.05 | $396.31 |
- 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
- $319.30 / $331.35 / $515.67
| Professional | | $319.30 | $331.35 | $515.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.23 / $407.04 / $646.91
| Professional | | $301.23 | $407.04 | $646.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.30 / $502.79 / $502.79
| Professional | | $378.30 | $502.79 | $502.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,806.74 / $1,806.74 / $1,806.74
| Facility | | $1,806.74 | $1,806.74 | $1,806.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,422.00 / $8,017.00
| Facility | | $641.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $268.70 / $348.06 / $1,544.00
| Professional | | $268.70 | $348.06 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $199.00 / $815.00
| Professional | | $3.00 | $199.00 | $815.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.70 / $410.68 / $653.30
| Professional | | $304.70 | $410.68 | $653.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.33 / $314.82 / $314.82
| Facility | | $286.33 | $314.82 | $314.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.33 / $314.82 / $331.50
| Professional | | $286.33 | $314.82 | $331.50 |
- 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
- $289.74 / $403.28 / $674.77
| Professional | | $289.74 | $403.28 | $674.77 |