- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,956.72 / $7,648.00 / $18,252.00
| Facility | | $1,956.72 | $7,648.00 | $18,252.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.26 / $314.64 / $401.14
| Professional | | $201.26 | $314.64 | $401.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.00 / $4,814.00 / $9,381.00
| Facility | | $2,060.00 | $4,814.00 | $9,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.45 / $337.46 / $542.46
| Professional | | $269.45 | $337.46 | $542.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.90 / $100.00 / $2,103.63
| Facility | | $63.90 | $100.00 | $2,103.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.31 / $705.31 / $1,050.00
| Facility | | $705.31 | $705.31 | $1,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.73 / $261.60 / $305.08
| Professional | | $249.73 | $261.60 | $305.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.00 / $393.93 / $393.93
| Professional | | $135.00 | $393.93 | $393.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,858.02 / $2,273.69 / $2,341.19
| Facility | | $1,858.02 | $2,273.69 | $2,341.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,382.56 / $2,452.64 / $2,854.43
| Professional | | $2,382.56 | $2,452.64 | $2,854.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.39 / $419.94 / $558.38
| Facility | | $317.39 | $419.94 | $558.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.92 / $279.95 / $349.95
| Professional | | $253.92 | $279.95 | $349.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,836.00 / $5,067.00 / $17,075.00
| Facility | | $1,836.00 | $5,067.00 | $17,075.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.16 / $350.40 / $836.94
| Professional | | $265.16 | $350.40 | $836.94 |