- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $1,819.00 / $7,197.00
| Facility | | $480.00 | $1,819.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.78 / $147.80 / $390.82
| Professional | | $123.78 | $147.80 | $390.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.19 / $144.44 / $279.20
| Professional | | $139.19 | $144.44 | $279.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.37 / $190.50 / $296.23
| Professional | | $139.37 | $190.50 | $296.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.37 / $440.37 / $440.37
| Professional | | $440.37 | $440.37 | $440.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.43 / $668.21 / $3,908.90
| Facility | | $502.43 | $668.21 | $3,908.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,266.00 / $7,799.00
| Facility | | $594.00 | $2,266.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.54 / $155.19 / $788.00
| Professional | | $128.54 | $155.19 | $788.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $340.00 / $372.30
| Professional | | $3.00 | $340.00 | $372.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.66 / $190.93 / $307.14
| Professional | | $150.66 | $190.93 | $307.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.50 / $360.50 / $360.50
| Facility | | $360.50 | $360.50 | $360.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.50 / $360.50 / $360.50
| Professional | | $360.50 | $360.50 | $360.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,219.00 / $3,742.00
| Facility | | $471.00 | $1,219.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.49 / $182.80 / $295.50
| Professional | | $125.49 | $182.80 | $295.50 |