- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.93 / $3,964.00 / $8,240.00
| Facility | | $494.93 | $3,964.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.35 / $442.89 / $606.48
| Professional | | $386.35 | $442.89 | $606.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.02 / $460.78 / $808.10
| Professional | | $444.02 | $460.78 | $808.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.78 / $445.33 / $713.99
| Professional | | $328.78 | $445.33 | $713.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.14 / $539.14 / $695.24
| Professional | | $539.14 | $539.14 | $695.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.00 / $4,761.00 / $8,247.00
| Facility | | $976.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.01 / $483.51 / $2,406.67
| Professional | | $389.01 | $483.51 | $2,406.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.20 / $470.20 / $470.20
| Professional | | $470.20 | $470.20 | $470.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.11 / $454.02 / $710.96
| Professional | | $335.11 | $454.02 | $710.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.21 / $387.76 / $438.04
| Facility | | $387.21 | $387.76 | $438.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.20 / $423.23 / $467.00
| Professional | | $385.20 | $423.23 | $467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $2,391.00 / $6,000.00
| Facility | | $637.00 | $2,391.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.23 / $508.67 / $833.48
| Professional | | $393.23 | $508.67 | $833.48 |