- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.00 / $6,012.00 / $9,907.00
| Facility | | $413.00 | $6,012.00 | $9,907.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.95 / $381.66 / $716.98
| Professional | | $321.95 | $381.66 | $716.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.09 / $439.05 / $439.05
| Professional | | $423.09 | $439.05 | $439.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.26 / $498.23 / $768.60
| Professional | | $387.26 | $498.23 | $768.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.91 / $696.55 / $696.55
| Professional | | $518.91 | $696.55 | $696.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,341.80 / $7,668.64 / $14,273.45
| Facility | | $3,341.80 | $7,668.64 | $14,273.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $692.41 / $5,982.00 / $10,247.00
| Facility | | $692.41 | $5,982.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.55 / $442.33 / $1,226.60
| Professional | | $328.55 | $442.33 | $1,226.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $599.20 / $1,099.50
| Professional | | $4.00 | $599.20 | $1,099.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.26 / $501.51 / $821.67
| Professional | | $387.26 | $501.51 | $821.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.36 / $392.52 / $449.52
| Facility | | $366.36 | $392.52 | $449.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.36 / $403.38 / $445.60
| Professional | | $366.36 | $403.38 | $445.60 |
- 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
- $368.59 / $494.58 / $862.04
| Professional | | $368.59 | $494.58 | $862.04 |