- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $6,393.00 / $13,229.00
| Facility | | $1,819.00 | $6,393.00 | $13,229.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.32 / $398.52 / $447.38
| Professional | | $250.32 | $398.52 | $447.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.00 / $10,355.00 / $24,288.00
| Facility | | $4,989.00 | $10,355.00 | $24,288.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.31 / $288.23 / $533.03
| Professional | | $227.31 | $288.23 | $533.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.42 / $414.42 / $7,227.90
| Facility | | $414.42 | $414.42 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.28 / $1,724.36 / $1,724.36
| Professional | | $346.28 | $1,724.36 | $1,724.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,357.00 / $47,648.00 / $71,078.00
| Facility | | $38,357.00 | $47,648.00 | $71,078.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.15 / $510.22 / $679.49
| Professional | | $340.15 | $510.22 | $679.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.42 / $597.00 / $74,999.25
| Facility | | $414.42 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.28 / $1,724.36 / $1,724.36
| Professional | | $346.28 | $1,724.36 | $1,724.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,846.00 / $14,050.00 / $48,691.00
| Facility | | $2,846.00 | $14,050.00 | $48,691.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.68 / $481.41 / $1,077.36
| Professional | | $371.68 | $481.41 | $1,077.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.25 / $350.25 / $350.25
| Facility | | $350.25 | $350.25 | $350.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.25 / $529.61 / $734.77
| Professional | | $350.25 | $529.61 | $734.77 |