- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.40 / $406.27 / $529.79
| Professional | | $346.40 | $406.27 | $529.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.01 / $442.09 / $442.09
| Professional | | $426.01 | $442.09 | $442.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.74 / $529.69 / $850.21
| Professional | | $407.74 | $529.69 | $850.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.65 / $673.34 / $673.34
| Professional | | $506.65 | $673.34 | $673.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.06 / $419.84 / $1,544.00
| Professional | | $363.06 | $419.84 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $500.30 / $1,100.59
| Professional | | $6.00 | $500.30 | $1,100.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.76 / $538.04 / $868.26
| Professional | | $413.76 | $538.04 | $868.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.78 / $421.78 / $536.10
| Facility | | $421.78 | $421.78 | $536.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.16 / $423.55 / $536.10
| Professional | | $409.16 | $423.55 | $536.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,747.00 / $2,824.00 / $5,678.00
| Facility | | $1,747.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.67 / $502.56 / $821.59
| Professional | | $388.67 | $502.56 | $821.59 |