- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.05 / $3,774.82
| Facility | | $0.02 | $0.05 | $3,774.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,142.50 / $5,877.02 / $5,877.02
| Professional | | $1,142.50 | $5,877.02 | $5,877.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $712.92 / $712.92 / $712.92
| Professional | | $712.92 | $712.92 | $712.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.39 / $1,350.05 / $3,032.71
| Facility | | $867.39 | $1,350.05 | $3,032.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.62 / $976.09 / $2,066.96
| Professional | | $430.62 | $976.09 | $2,066.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.83 / $1,233.90 / $1,736.60
| Professional | | $543.83 | $1,233.90 | $1,736.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $658.08 / $3,774.82
| Facility | | $0.02 | $658.08 | $3,774.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.03 / $3,774.82 / $5,877.02
| Professional | | $0.03 | $3,774.82 | $5,877.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,352.72 / $1,371.00 / $1,828.00
| Professional | | $1,352.72 | $1,371.00 | $1,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $889.75 / $1,520.60 / $3,032.71
| Facility | | $889.75 | $1,520.60 | $3,032.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.28 / $978.29 / $2,066.96
| Professional | | $481.28 | $978.29 | $2,066.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $914.00 / $1,005.40
| Facility | | $914.00 | $914.00 | $1,005.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $914.00 / $914.00 / $1,005.40
| Professional | | $914.00 | $914.00 | $1,005.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.88 / $548.40 / $1,279.59
| Professional | | $383.88 | $548.40 | $1,279.59 |