- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $3,839.00 / $8,451.00
| Facility | | $540.00 | $3,839.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.06 / $368.94 / $631.16
| Professional | | $313.06 | $368.94 | $631.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.72 / $680.72 / $680.72
| Professional | | $680.72 | $680.72 | $680.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,374.55 / $8,639.91 / $17,057.00
| Facility | | $5,374.55 | $8,639.91 | $17,057.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.34 / $385.35 / $385.35
| Professional | | $371.34 | $385.35 | $385.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.21 / $472.94 / $751.35
| Professional | | $354.21 | $472.94 | $751.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.71 / $585.88 / $585.88
| Professional | | $440.71 | $585.88 | $585.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,255.18 / $12,323.67 / $20,204.91
| Facility | | $4,255.18 | $12,323.67 | $20,204.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $3,839.00 / $8,427.00
| Facility | | $594.00 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.68 / $405.84 / $1,426.00
| Professional | | $326.68 | $405.84 | $1,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $463.90 / $948.40
| Professional | | $6.00 | $463.90 | $948.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.16 / $480.66 / $784.37
| Professional | | $373.16 | $480.66 | $784.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.01 / $366.01 / $374.14
| Facility | | $366.01 | $366.01 | $374.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.52 / $368.11 / $385.72
| Professional | | $354.52 | $368.11 | $385.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.13 / $448.18 / $741.77
| Professional | | $338.13 | $448.18 | $741.77 |