- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.58 / $4,262.00 / $8,451.00
| Facility | | $471.58 | $4,262.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.29 / $441.53 / $722.79
| Professional | | $328.29 | $441.53 | $722.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.46 / $553.59 / $553.59
| Professional | | $533.46 | $553.59 | $553.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.86 / $504.91 / $851.58
| Professional | | $340.86 | $504.91 | $851.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $647.99 / $833.13 / $861.35
| Professional | | $647.99 | $833.13 | $861.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,724.84 / $3,724.84 / $3,724.84
| Facility | | $3,724.84 | $3,724.84 | $3,724.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $5,342.00 / $9,617.00
| Facility | | $1,020.00 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.21 / $471.58 / $2,319.78
| Professional | | $332.21 | $471.58 | $2,319.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.20 / $454.20 / $481.10
| Professional | | $454.20 | $454.20 | $481.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.84 / $679.84 / $679.84
| Facility | | $679.84 | $679.84 | $679.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.59 / $516.72 / $896.68
| Professional | | $368.59 | $516.72 | $896.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.99 / $391.67 / $524.14
| Facility | | $296.99 | $391.67 | $524.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.56 / $417.33 / $563.15
| Professional | | $381.56 | $417.33 | $563.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $2,974.56 / $6,195.30
| Facility | | $912.00 | $2,974.56 | $6,195.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.60 / $552.33 / $940.32
| Professional | | $436.60 | $552.33 | $940.32 |