- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,992.00 / $8,050.00 / $19,011.00
| Facility | | $1,992.00 | $8,050.00 | $19,011.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.18 / $229.13 / $383.28
| Professional | | $199.18 | $229.13 | $383.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,456.00 / $6,048.00 / $13,697.00
| Facility | | $2,456.00 | $6,048.00 | $13,697.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.11 / $304.11 / $475.92
| Professional | | $234.11 | $304.11 | $475.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.09 / $100.00 / $9,778.71
| Facility | | $66.09 | $100.00 | $9,778.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.37 / $207.70 / $340.31
| Professional | | $188.37 | $207.70 | $340.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.93 / $393.93 / $393.93
| Professional | | $393.93 | $393.93 | $393.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.55 / $10,168.04 / $10,168.04
| Facility | | $1,148.55 | $10,168.04 | $10,168.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,767.60 / $1,818.24 / $2,117.17
| Professional | | $1,767.60 | $1,818.24 | $2,117.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.07 / $324.54 / $410.26
| Facility | | $276.07 | $324.54 | $410.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.37 / $207.70 / $259.63
| Professional | | $188.37 | $207.70 | $259.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,116.00 / $9,759.00 / $22,073.00
| Facility | | $5,116.00 | $9,759.00 | $22,073.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.59 / $288.52 / $670.65
| Professional | | $194.59 | $288.52 | $670.65 |