- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.06 / $424.21 / $620.79
| Professional | | $388.06 | $424.21 | $620.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.90 / $478.29 / $778.52
| Professional | | $460.90 | $478.29 | $778.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.24 / $525.24 / $525.24
| Facility | | $525.24 | $525.24 | $525.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.85 / $521.77 / $884.63
| Professional | | $347.85 | $521.77 | $884.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.94 / $776.09 / $961.99
| Professional | | $556.94 | $776.09 | $961.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,077.00 / $8,017.00
| Facility | | $954.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.06 / $500.28 / $2,467.00
| Professional | | $388.06 | $500.28 | $2,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.30 / $393.30 / $932.70
| Professional | | $393.30 | $393.30 | $932.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.24 / $525.24 / $525.24
| Facility | | $525.24 | $525.24 | $525.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.49 / $538.80 / $905.26
| Professional | | $377.49 | $538.80 | $905.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.37 / $445.30 / $445.30
| Facility | | $388.37 | $445.30 | $445.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.37 / $445.30 / $476.94
| Professional | | $388.37 | $445.30 | $476.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.40 / $532.91 / $831.66
| Professional | | $378.40 | $532.91 | $831.66 |