- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.69 / $361.36 / $484.79
| Professional | | $280.69 | $361.36 | $484.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.05 / $385.06 / $400.81
| Professional | | $371.05 | $385.06 | $400.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.93 / $425.93 / $425.93
| Facility | | $425.93 | $425.93 | $425.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.07 / $395.58 / $680.71
| Professional | | $279.07 | $395.58 | $680.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.91 / $603.23 / $773.66
| Professional | | $447.91 | $603.23 | $773.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,650.00 / $8,650.00 / $8,650.00
| Facility | | $8,650.00 | $8,650.00 | $8,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.42 / $393.54 / $1,909.33
| Professional | | $332.42 | $393.54 | $1,909.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.00 / $352.00 / $788.50
| Professional | | $352.00 | $352.00 | $788.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.93 / $425.93 / $425.93
| Facility | | $425.93 | $425.93 | $425.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.79 / $407.13 / $684.51
| Professional | | $295.79 | $407.13 | $684.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.39 / $363.23 / $363.23
| Facility | | $326.39 | $363.23 | $363.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.39 / $363.23 / $391.62
| Professional | | $326.39 | $363.23 | $391.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $5,678.00
| Facility | | $1,175.00 | $2,715.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.74 / $389.60 / $640.59
| Professional | | $287.74 | $389.60 | $640.59 |