- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.72 / $412.77 / $555.71
| Professional | | $385.72 | $412.77 | $555.71 |
- 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
- $402.07 / $417.24 / $740.48
| Professional | | $402.07 | $417.24 | $740.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.42 / $423.02 / $725.80
| Professional | | $322.42 | $423.02 | $725.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.35 / $485.35 / $625.87
| Professional | | $485.35 | $485.35 | $625.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.07 / $491.28 / $2,605.00
| Professional | | $394.07 | $491.28 | $2,605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $748.20 / $1,048.00
| Professional | | $5.00 | $748.20 | $1,048.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.35 / $429.11 / $725.80
| Professional | | $335.35 | $429.11 | $725.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.79 / $394.09 / $394.09
| Facility | | $322.79 | $394.09 | $394.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.79 / $394.09 / $418.63
| Professional | | $322.79 | $394.09 | $418.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $4,815.00
| Facility | | $1,175.00 | $2,715.00 | $4,815.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.54 / $464.61 / $787.80
| Professional | | $345.54 | $464.61 | $787.80 |