- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,208.95 / $5,310.00 / $16,713.00
| Facility | | $1,208.95 | $5,310.00 | $16,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.72 / $308.70 / $1,728.21
| Professional | | $277.72 | $308.70 | $1,728.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,456.00 / $7,007.00 / $14,981.00
| Facility | | $2,456.00 | $7,007.00 | $14,981.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.13 / $471.06 / $926.82
| Professional | | $320.13 | $471.06 | $926.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $5,487.90
| Facility | | $66.00 | $100.00 | $5,487.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.81 / $122.60 / $301.45
| Professional | | $91.81 | $122.60 | $301.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,101.23 / $3,106.72 / $5,980.00
| Facility | | $3,101.23 | $3,106.72 | $5,980.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.33 / $412.81 / $882.40
| Professional | | $315.33 | $412.81 | $882.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.09 / $388.50 / $2,214.06
| Professional | | $246.09 | $388.50 | $2,214.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.81 / $444.73 / $796.59
| Professional | | $320.81 | $444.73 | $796.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,870.20 / $8,957.00
| Facility | | $55.00 | $1,870.20 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,033.32 / $3,033.32 / $3,033.32
| Professional | | $3,033.32 | $3,033.32 | $3,033.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.25 / $428.55 / $596.59
| Facility | | $342.25 | $428.55 | $596.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.32 / $430.34 / $875.14
| Professional | | $317.32 | $430.34 | $875.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,072.32 / $1,072.32 / $1,072.32
| Professional | | $1,072.32 | $1,072.32 | $1,072.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.88 / $353.12 / $431.59
| Professional | | $313.88 | $353.12 | $431.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,523.00 / $7,359.00 / $15,471.00
| Facility | | $3,523.00 | $7,359.00 | $15,471.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.63 / $342.87 / $722.22
| Professional | | $259.63 | $342.87 | $722.22 |