- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,505.00 / $8,017.00
| Facility | | $617.00 | $2,505.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.31 / $323.98 / $582.04
| Professional | | $288.31 | $323.98 | $582.04 |
- 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
- $351.89 / $365.17 / $365.17
| Professional | | $351.89 | $365.17 | $365.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.75 / $422.25 / $668.59
| Professional | | $316.75 | $422.25 | $668.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.98 / $560.64 / $563.05
| Professional | | $421.98 | $560.64 | $563.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,635.18 / $8,635.18 / $8,635.18
| Facility | | $8,635.18 | $8,635.18 | $8,635.18 |
- 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
- $307.04 / $344.61 / $1,541.00
| Professional | | $307.04 | $344.61 | $1,541.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $293.80 / $935.60
| Professional | | $4.00 | $293.80 | $935.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.04 / $423.56 / $729.34
| Professional | | $326.04 | $423.56 | $729.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.78 / $350.05 / $350.05
| Facility | | $241.78 | $350.05 | $350.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.78 / $350.05 / $372.69
| Professional | | $241.78 | $350.05 | $372.69 |
- 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
- $291.87 / $419.46 / $703.10
| Professional | | $291.87 | $419.46 | $703.10 |