- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,820.00 / $6,880.00 / $17,902.00
| Facility | | $1,820.00 | $6,880.00 | $17,902.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.15 / $549.50 / $707.56
| Professional | | $492.15 | $549.50 | $707.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,518.00 / $7,309.00 / $15,399.00
| Facility | | $3,518.00 | $7,309.00 | $15,399.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.11 / $309.85 / $525.50
| Professional | | $234.11 | $309.85 | $525.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.90 / $100.00 / $10,033.91
| Facility | | $65.90 | $100.00 | $10,033.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.26 / $2,468.26 / $2,917.04
| Facility | | $2,468.26 | $2,468.26 | $2,917.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.44 / $263.38 / $307.14
| Professional | | $251.44 | $263.38 | $307.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,739.37 / $2,739.37 / $2,876.34
| Professional | | $2,739.37 | $2,739.37 | $2,876.34 |
- 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
- $1,247.35 / $11,082.10 / $11,082.10
| Facility | | $1,247.35 | $11,082.10 | $11,082.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,505.14 / $3,505.14 / $3,505.14
| Professional | | $3,505.14 | $3,505.14 | $3,505.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.08 / $503.40 / $859.57
| Facility | | $395.08 | $503.40 | $859.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.67 / $281.88 / $352.35
| Professional | | $255.67 | $281.88 | $352.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,116.00 / $9,713.00 / $21,278.00
| Facility | | $5,116.00 | $9,713.00 | $21,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.58 / $712.59 / $1,690.60
| Professional | | $467.58 | $712.59 | $1,690.60 |