- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,497.00 / $9,666.00 / $22,210.00
| Facility | | $3,497.00 | $9,666.00 | $22,210.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.04 / $48.85 / $582.07
| Professional | | $43.04 | $48.85 | $582.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,537.00 / $7,764.00 / $16,461.00
| Facility | | $3,537.00 | $7,764.00 | $16,461.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.84 / $276.92 / $393.01
| Professional | | $47.84 | $276.92 | $393.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.09 / $100.00 / $7,282.23
| Facility | | $66.09 | $100.00 | $7,282.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $40.00
| Professional | | $40.00 | $40.00 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,839.74 / $8,839.74 / $10,446.96
| Facility | | $8,839.74 | $8,839.74 | $10,446.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,810.66 / $9,810.66 / $10,301.19
| Professional | | $9,810.66 | $9,810.66 | $10,301.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.93 / $393.93 / $393.93
| Professional | | $393.93 | $393.93 | $393.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,743.70 / $39,689.10 / $39,689.10
| Facility | | $1,743.70 | $39,689.10 | $39,689.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,682.56 / $2,757.36 / $3,214.88
| Professional | | $2,682.56 | $2,757.36 | $3,214.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.85 / $477.40 / $622.53
| Facility | | $63.85 | $477.40 | $622.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.31 / $380.31 / $394.03
| Professional | | $380.31 | $380.31 | $394.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,830.00 / $18,315.00 / $45,545.00
| Facility | | $8,830.00 | $18,315.00 | $45,545.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.15 / $62.98 / $178.31
| Professional | | $42.15 | $62.98 | $178.31 |