- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.00 / $3,627.00 / $7,799.00
| Facility | | $655.00 | $3,627.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.80 / $309.64 / $536.19
| Professional | | $270.80 | $309.64 | $536.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.82 / $345.38 / $568.52
| Professional | | $332.82 | $345.38 | $568.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.98 / $408.18 / $643.50
| Professional | | $313.98 | $408.18 | $643.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.71 / $528.70 / $528.70
| Professional | | $397.71 | $528.70 | $528.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,776.72 / $2,776.72 / $6,715.99
| Facility | | $2,776.72 | $2,776.72 | $6,715.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.00 / $3,745.00 / $8,017.00
| Facility | | $749.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.54 / $358.99 / $1,544.00
| Professional | | $297.54 | $358.99 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $357.00 / $868.30
| Professional | | $3.00 | $357.00 | $868.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.48 / $411.84 / $681.60
| Professional | | $314.48 | $411.84 | $681.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.99 / $328.79 / $328.79
| Facility | | $300.99 | $328.79 | $328.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.99 / $328.79 / $348.53
| Professional | | $300.99 | $328.79 | $348.53 |
- 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
- $295.58 / $402.40 / $688.40
| Professional | | $295.58 | $402.40 | $688.40 |