- 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
- $385.91 / $445.14 / $698.08
| Professional | | $385.91 | $445.14 | $698.08 |
- 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
- $448.46 / $465.39 / $845.90
| Professional | | $448.46 | $465.39 | $845.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.28 / $506.28 / $506.28
| Facility | | $506.28 | $506.28 | $506.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.08 / $564.67 / $901.43
| Professional | | $423.08 | $564.67 | $901.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.72 / $697.62 / $908.07
| Professional | | $525.72 | $697.62 | $908.07 |
- 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
- $392.91 / $515.33 / $2,467.00
| Professional | | $392.91 | $515.33 | $2,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.70 / $467.70 / $1,025.20
| Professional | | $467.70 | $467.70 | $1,025.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.28 / $506.28 / $506.28
| Facility | | $506.28 | $506.28 | $506.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.08 / $571.15 / $928.76
| Professional | | $423.08 | $571.15 | $928.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.72 / $439.72 / $466.27
| Facility | | $439.72 | $439.72 | $466.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.53 / $439.72 / $466.27
| Professional | | $429.53 | $439.72 | $466.27 |
- 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
- $440.36 / $568.19 / $897.45
| Professional | | $440.36 | $568.19 | $897.45 |