- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.13 / $6,322.00 / $17,380.00
| Facility | | $436.13 | $6,322.00 | $17,380.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.20 / $364.51 / $1,425.43
| Professional | | $241.20 | $364.51 | $1,425.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $5,944.00 / $13,012.00
| Facility | | $2,143.00 | $5,944.00 | $13,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.52 / $396.58 / $797.67
| Professional | | $281.52 | $396.58 | $797.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $7,908.14
| Facility | | $66.00 | $100.00 | $7,908.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.46 / $356.37 / $774.48
| Professional | | $249.46 | $356.37 | $774.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,277.00 / $3,101.23 / $5,554.45
| Facility | | $2,277.00 | $3,101.23 | $5,554.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.02 / $454.77 / $825.41
| Professional | | $292.02 | $454.77 | $825.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.35 / $354.15 / $683.10
| Professional | | $175.35 | $354.15 | $683.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.82 / $445.53 / $770.39
| Professional | | $276.82 | $445.53 | $770.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,271.11 / $1,380.59 / $26,542.00
| Facility | | $1,271.11 | $1,380.59 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,986.96 / $2,943.76 / $3,398.33
| Professional | | $1,986.96 | $2,943.76 | $3,398.33 |
- 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
- $325.02 / $436.55 / $657.80
| Facility | | $325.02 | $436.55 | $657.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.45 / $487.32 / $910.68
| Professional | | $294.45 | $487.32 | $910.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $884.43 / $884.43 / $1,400.15
| Professional | | $884.43 | $884.43 | $1,400.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.49 / $331.70 / $562.44
| Professional | | $245.49 | $331.70 | $562.44 |
- 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
- $326.62 / $421.60 / $1,065.98
| Professional | | $326.62 | $421.60 | $1,065.98 |