- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $3,224.00 / $11,453.00
| Facility | | $767.00 | $3,224.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.68 / $477.54 / $526.62
| Professional | | $426.68 | $477.54 | $526.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,161.41 / $10,528.23 / $23,653.30
| Facility | | $6,161.41 | $10,528.23 | $23,653.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.40 / $575.40 / $575.40
| Facility | | $575.40 | $575.40 | $575.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,397.90 / $2,397.90 / $2,397.90
| Professional | | $2,397.90 | $2,397.90 | $2,397.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,891.88 / $28,334.00 / $28,334.00
| Facility | | $1,891.88 | $28,334.00 | $28,334.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,638.56 / $3,740.24 / $4,359.89
| Professional | | $3,638.56 | $3,740.24 | $4,359.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.63 / $556.22 / $1,017.08
| Facility | | $467.63 | $556.22 | $1,017.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.11 / $4,663.00 / $5,830.00
| Professional | | $482.11 | $4,663.00 | $5,830.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.90 / $575.40 / $1,017.08
| Facility | | $433.90 | $575.40 | $1,017.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.11 / $655.49 / $2,397.90
| Professional | | $482.11 | $655.49 | $2,397.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,435.00 / $4,114.00 / $8,600.00
| Facility | | $1,435.00 | $4,114.00 | $8,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.07 / $547.94 / $869.89
| Professional | | $409.07 | $547.94 | $869.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.62 / $741.62 / $1,001.19
| Professional | | $741.62 | $741.62 | $1,001.19 |