- 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
- $278.41 / $443.63 / $497.98
| Professional | | $278.41 | $443.63 | $497.98 |
- 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
- $235.81 / $299.00 / $560.37
| Professional | | $235.81 | $299.00 | $560.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.00 / $438.00 / $7,227.90
| Facility | | $438.00 | $438.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.86 / $1,730.62 / $1,730.62
| Professional | | $346.86 | $1,730.62 | $1,730.62 |
- 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
- $341.41 / $512.12 / $718.21
| Professional | | $341.41 | $512.12 | $718.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.00 / $597.00 / $74,999.25
| Facility | | $438.00 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.86 / $1,730.62 / $1,730.62
| Professional | | $346.86 | $1,730.62 | $1,730.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,846.00 / $14,155.00 / $52,250.00
| Facility | | $2,846.00 | $14,155.00 | $52,250.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.05 / $510.89 / $1,278.98
| Professional | | $360.05 | $510.89 | $1,278.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.21 / $370.21 / $370.21
| Facility | | $370.21 | $370.21 | $370.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.21 / $531.58 / $776.65
| Professional | | $370.21 | $531.58 | $776.65 |