- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,817.98 / $4,648.00 / $9,868.00
| Facility | | $1,817.98 | $4,648.00 | $9,868.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.57 / $486.85 / $546.50
| Professional | | $305.57 | $486.85 | $546.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,393.00 / $4,123.00 / $9,074.00
| Facility | | $2,393.00 | $4,123.00 | $9,074.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.74 / $276.10 / $517.45
| Professional | | $217.74 | $276.10 | $517.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.84 / $393.84 / $10,297.11
| Facility | | $393.84 | $393.84 | $10,297.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.46 / $1,643.28 / $1,643.28
| Professional | | $329.46 | $1,643.28 | $1,643.28 |
- 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
- $324.14 / $486.21 / $645.79
| Professional | | $324.14 | $486.21 | $645.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.84 / $597.00 / $74,999.25
| Facility | | $393.84 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.46 / $1,643.28 / $1,643.28
| Professional | | $329.46 | $1,643.28 | $1,643.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,768.00 / $3,961.00 / $8,312.00
| Facility | | $1,768.00 | $3,961.00 | $8,312.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.77 / $561.95 / $1,403.63
| Professional | | $367.77 | $561.95 | $1,403.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.88 / $332.88 / $332.88
| Facility | | $332.88 | $332.88 | $332.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.88 / $504.69 / $698.34
| Professional | | $332.88 | $504.69 | $698.34 |