- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.00 / $10,596.56 / $22,024.00
| Facility | | $988.00 | $10,596.56 | $22,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.02 / $51.18 / $582.07
| Professional | | $31.02 | $51.18 | $582.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,816.01 / $24,075.80 / $46,054.28
| Facility | | $15,816.01 | $24,075.80 | $46,054.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.64 / $829.92 / $3,306.23
| Professional | | $332.64 | $829.92 | $3,306.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,342.74 / $10,342.74 / $10,342.74
| Facility | | $10,342.74 | $10,342.74 | $10,342.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,538.52 / $9,070.24 / $38,471.14
| Facility | | $6,538.52 | $9,070.24 | $38,471.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,159.25 / $6,538.52 / $12,443.52
| Professional | | $1,159.25 | $6,538.52 | $12,443.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Professional | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.03 / $8,107.18 / $11,440.58
| Facility | | $688.03 | $8,107.18 | $11,440.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.59 / $66.59 / $517.78
| Facility | | $66.59 | $66.59 | $517.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.78 / $773.52 / $1,027.74
| Professional | | $517.78 | $773.52 | $1,027.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,567.73 / $24,075.80 / $46,054.28
| Facility | | $17,567.73 | $24,075.80 | $46,054.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.64 / $726.93 / $1,003.27
| Professional | | $332.64 | $726.93 | $1,003.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $13,441.00 / $26,100.00
| Facility | | $3,340.00 | $13,441.00 | $26,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.69 / $116.17 / $983.72
| Professional | | $65.69 | $116.17 | $983.72 |