- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,594.00 / $7,542.00
| Facility | | $652.00 | $2,594.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.90 / $422.07 / $607.41
| Professional | | $371.90 | $422.07 | $607.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,718.74 / $4,598.72 / $9,052.84
| Facility | | $2,718.74 | $4,598.72 | $9,052.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.08 / $558.29 / $636.11
| Professional | | $441.08 | $558.29 | $636.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.18 / $412.18 / $412.18
| Facility | | $412.18 | $412.18 | $412.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.79 / $2,266.79 / $2,266.79
| Facility | | $2,266.79 | $2,266.79 | $2,266.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.67 / $578.67 / $876.99
| Professional | | $459.67 | $578.67 | $876.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,957.00
| Facility | | $55.00 | $55.00 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,452.72 / $3,557.04 / $4,013.18
| Professional | | $3,452.72 | $3,557.04 | $4,013.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.11 / $494.93 / $949.91
| Facility | | $395.11 | $494.93 | $949.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.95 / $710.69 / $836.10
| Professional | | $510.95 | $710.69 | $836.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.62 / $518.41 / $1,111.57
| Facility | | $391.62 | $518.41 | $1,111.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.27 / $586.23 / $897.11
| Professional | | $459.27 | $586.23 | $897.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.39 / $485.23 / $771.11
| Professional | | $353.39 | $485.23 | $771.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.44 / $449.94 / $627.47
| Professional | | $396.44 | $449.94 | $627.47 |