- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $5,298.00 / $10,170.00
| Facility | | $1,819.00 | $5,298.00 | $10,170.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.70 / $459.82 / $521.79
| Professional | | $297.70 | $459.82 | $521.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,568.00 / $7,608.00 / $14,193.00
| Facility | | $4,568.00 | $7,608.00 | $14,193.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.70 / $389.07 / $666.40
| Professional | | $330.70 | $389.07 | $666.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.25 / $560.25 / $12,319.50
| Facility | | $560.25 | $560.25 | $12,319.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.25 / $560.25 / $560.25
| Professional | | $560.25 | $560.25 | $560.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.96 / $467.96 / $7,227.90
| Facility | | $467.96 | $467.96 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.99 / $1,948.87 / $1,948.87
| Professional | | $390.99 | $1,948.87 | $1,948.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.46 / $576.69 / $767.33
| Professional | | $384.46 | $576.69 | $767.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.96 / $597.00 / $74,999.25
| Facility | | $467.96 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.99 / $1,948.87 / $1,948.87
| Professional | | $390.99 | $1,948.87 | $1,948.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.00 / $5,963.00 / $11,098.00
| Facility | | $2,337.00 | $5,963.00 | $11,098.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.05 / $531.15 / $1,203.27
| Professional | | $404.05 | $531.15 | $1,203.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.53 / $395.53 / $395.53
| Facility | | $395.53 | $395.53 | $395.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.53 / $598.60 / $829.77
| Professional | | $395.53 | $598.60 | $829.77 |