- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.00 / $4,753.00 / $16,550.00
| Facility | | $1,093.00 | $4,753.00 | $16,550.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.80 / $836.87 / $1,047.03
| Professional | | $578.80 | $836.87 | $1,047.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,760.21 / $34,750.72 / $69,728.57
| Facility | | $19,760.21 | $34,750.72 | $69,728.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.21 / $404.21 / $404.21
| Professional | | $404.21 | $404.21 | $404.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,997.37 / $34,997.37 / $34,997.37
| Facility | | $34,997.37 | $34,997.37 | $34,997.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,300.98 / $37,300.98 / $37,300.98
| Facility | | $37,300.98 | $37,300.98 | $37,300.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,900.85 / $147,391.15 / $147,391.15
| Facility | | $3,900.85 | $147,391.15 | $147,391.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,024.96 / $6,454.32 / $7,191.23
| Professional | | $6,024.96 | $6,454.32 | $7,191.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.77 / $804.48 / $1,705.50
| Facility | | $494.77 | $804.48 | $1,705.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.16 / $855.14 / $15,626.00
| Professional | | $482.16 | $855.14 | $15,626.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.29 / $836.88 / $1,705.50
| Facility | | $522.29 | $836.88 | $1,705.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $886.65 / $1,429.94 / $1,682.28
| Professional | | $886.65 | $1,429.94 | $1,682.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,503.00 / $19,002.00 / $40,083.00
| Facility | | $7,503.00 | $19,002.00 | $40,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $757.02 / $993.58 / $1,608.66
| Professional | | $757.02 | $993.58 | $1,608.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.16 / $588.37 / $663.44
| Professional | | $482.16 | $588.37 | $663.44 |