- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,220.00 / $6,677.00 / $14,700.00
| Facility | | $2,220.00 | $6,677.00 | $14,700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.97 / $58.04 / $187.05
| Professional | | $34.97 | $58.04 | $187.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.00 / $9,750.00 / $16,411.00
| Facility | | $4,989.00 | $9,750.00 | $16,411.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.38 / $298.45 / $559.37
| Professional | | $235.38 | $298.45 | $559.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.15 / $424.15 / $7,227.90
| Facility | | $424.15 | $424.15 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.80 / $1,766.48 / $1,766.48
| Professional | | $354.80 | $1,766.48 | $1,766.48 |
- 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
- $348.43 / $522.64 / $695.54
| Professional | | $348.43 | $522.64 | $695.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.15 / $597.00 / $74,999.25
| Facility | | $424.15 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.80 / $1,766.48 / $1,766.48
| Professional | | $354.80 | $1,766.48 | $1,766.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,705.00 / $7,719.00 / $17,688.00
| Facility | | $2,705.00 | $7,719.00 | $17,688.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.43 / $85.76 / $418.48
| Professional | | $52.43 | $85.76 | $418.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.52 / $358.52 / $358.52
| Facility | | $358.52 | $358.52 | $358.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.52 / $542.50 / $752.13
| Professional | | $358.52 | $542.50 | $752.13 |