- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $5,370.00 / $10,686.00
| Facility | | $1,819.00 | $5,370.00 | $10,686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $574.22 / $914.21 / $1,026.24
| Professional | | $574.22 | $914.21 | $1,026.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.00 / $9,750.00 / $16,411.00
| Facility | | $4,989.00 | $9,750.00 | $16,411.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.10 / $425.35 / $721.60
| Professional | | $358.10 | $425.35 | $721.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,511.50 / $5,511.50 / $16,534.50
| Facility | | $5,511.50 | $5,511.50 | $16,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.92 / $415.92 / $7,227.90
| Facility | | $415.92 | $415.92 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.45 / $1,732.16 / $1,732.16
| Professional | | $347.45 | $1,732.16 | $1,732.16 |
- 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
- $341.65 / $512.47 / $682.00
| Professional | | $341.65 | $512.47 | $682.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.92 / $597.00 / $74,999.25
| Facility | | $415.92 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.45 / $1,732.16 / $1,732.16
| Professional | | $347.45 | $1,732.16 | $1,732.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,705.00 / $7,719.00 / $17,688.00
| Facility | | $2,705.00 | $7,719.00 | $17,688.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.31 / $1,056.57 / $2,471.46
| Professional | | $434.31 | $1,056.57 | $2,471.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.55 / $351.55 / $351.55
| Facility | | $351.55 | $351.55 | $351.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.55 / $531.94 / $737.50
| Professional | | $351.55 | $531.94 | $737.50 |