- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.17 / $10,596.56 / $22,024.00
| Facility | | $420.17 | $10,596.56 | $22,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.89 / $420.17 / $538.96
| Professional | | $254.89 | $420.17 | $538.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,816.01 / $24,075.80 / $46,054.28
| Facility | | $15,816.01 | $24,075.80 | $46,054.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.64 / $827.09 / $3,064.43
| Professional | | $484.64 | $827.09 | $3,064.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,770.97 / $15,770.97 / $15,770.97
| Facility | | $15,770.97 | $15,770.97 | $15,770.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,332.37 / $13,830.62 / $38,471.14
| Facility | | $8,332.37 | $13,830.62 | $38,471.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,074.18 / $9,970.17 / $18,974.29
| Professional | | $1,074.18 | $9,970.17 | $18,974.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $50.00 / $50.00
| Professional | | $45.00 | $50.00 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.23 / $7,434.84 / $14,167.55
| Facility | | $306.23 | $7,434.84 | $14,167.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.85 / $479.85 / $543.15
| Facility | | $479.85 | $479.85 | $543.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.05 / $798.95 / $956.24
| Professional | | $507.05 | $798.95 | $956.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,567.73 / $24,075.80 / $46,054.28
| Facility | | $17,567.73 | $24,075.80 | $46,054.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.64 / $690.27 / $929.78
| Professional | | $484.64 | $690.27 | $929.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $13,441.00 / $26,100.00
| Facility | | $3,340.00 | $13,441.00 | $26,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.97 / $743.37 / $1,087.81
| Professional | | $523.97 | $743.37 | $1,087.81 |