- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $2,371.00 / $7,629.00
| Facility | | $480.00 | $2,371.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.51 / $271.10 / $432.43
| Professional | | $237.51 | $271.10 | $432.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $5,951.00 / $8,887.00
| Facility | | $2,800.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.80 / $385.14 / $502.74
| Professional | | $254.80 | $385.14 | $502.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.14 / $365.40 / $584.46
| Professional | | $275.14 | $365.40 | $584.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.52 / $455.42 / $455.42
| Professional | | $342.52 | $455.42 | $455.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,715.05 / $4,989.47 / $6,715.99
| Facility | | $1,715.05 | $4,989.47 | $6,715.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,371.00 / $7,888.62
| Facility | | $540.00 | $2,371.00 | $7,888.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.20 / $380.93 / $1,269.00
| Professional | | $257.20 | $380.93 | $1,269.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $335.20 / $736.40
| Professional | | $4.00 | $335.20 | $736.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.14 / $367.89 / $619.41
| Professional | | $286.14 | $367.89 | $619.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.70 / $284.70 / $342.06
| Facility | | $284.70 | $284.70 | $342.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.55 / $286.57 / $342.06
| Professional | | $275.55 | $286.57 | $342.06 |
- 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
- $261.86 / $346.60 / $574.46
| Professional | | $261.86 | $346.60 | $574.46 |