- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.00 / $2,679.00 / $8,017.00
| Facility | | $379.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.32 / $224.15 / $328.92
| Professional | | $170.32 | $224.15 | $328.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.92 / $263.51 / $263.51
| Professional | | $253.92 | $263.51 | $263.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.19 / $327.19 / $327.19
| Facility | | $327.19 | $327.19 | $327.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.50 / $264.91 / $442.80
| Professional | | $184.50 | $264.91 | $442.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.37 / $404.85 / $520.54
| Professional | | $301.37 | $404.85 | $520.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,679.00 / $8,017.00
| Facility | | $918.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.96 / $265.05 / $1,283.25
| Professional | | $177.96 | $265.05 | $1,283.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.89 / $280.50 / $540.29
| Professional | | $272.89 | $280.50 | $540.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.19 / $327.19 / $327.19
| Facility | | $327.19 | $327.19 | $327.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.89 / $270.70 / $446.78
| Professional | | $193.89 | $270.70 | $446.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.67 / $225.26 / $269.35
| Facility | | $186.67 | $225.26 | $269.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.67 / $242.07 / $264.50
| Professional | | $186.67 | $242.07 | $264.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,219.00 / $3,742.00
| Facility | | $435.00 | $1,219.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.17 / $302.45 / $438.38
| Professional | | $230.17 | $302.45 | $438.38 |