- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.78 / $4,761.00 / $9,519.00
| Facility | | $242.78 | $4,761.00 | $9,519.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.33 / $223.68 / $721.05
| Professional | | $183.33 | $223.68 | $721.05 |
- 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
- $246.17 / $255.46 / $341.55
| Professional | | $246.17 | $255.46 | $341.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.02 / $290.77 / $459.13
| Professional | | $228.02 | $290.77 | $459.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.06 / $404.93 / $404.93
| Professional | | $302.06 | $404.93 | $404.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,500.50 / $7,762.55 / $9,102.15
| Facility | | $6,500.50 | $7,762.55 | $9,102.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,470.00 / $9,900.00
| Facility | | $1,013.00 | $5,470.00 | $9,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.16 / $259.11 / $978.00
| Professional | | $192.16 | $259.11 | $978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,240.66 / $5,240.66 / $5,240.66
| Facility | | $5,240.66 | $5,240.66 | $5,240.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $342.30 / $650.29
| Professional | | $4.00 | $342.30 | $650.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.02 / $293.31 / $474.83
| Professional | | $228.02 | $293.31 | $474.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.16 / $245.03 / $274.86
| Facility | | $218.16 | $245.03 | $274.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.16 / $236.47 / $266.56
| Professional | | $218.16 | $236.47 | $266.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $4,789.00
| Facility | | $1,175.00 | $2,715.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.96 / $288.39 / $469.89
| Professional | | $214.96 | $288.39 | $469.89 |