- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $3,066.00 / $7,763.00
| Facility | | $540.00 | $3,066.00 | $7,763.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.83 / $271.14 / $371.34
| Professional | | $178.83 | $271.14 | $371.34 |
- 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
- $348.57 / $361.72 / $361.72
| Professional | | $348.57 | $361.72 | $361.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.16 / $381.16 / $381.16
| Facility | | $381.16 | $381.16 | $381.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.04 / $312.70 / $557.09
| Professional | | $204.04 | $312.70 | $557.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.50 / $566.66 / $726.31
| Professional | | $420.50 | $566.66 | $726.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.23 / $1,059.23 / $14,968.75
| Facility | | $1,059.23 | $1,059.23 | $14,968.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.19 / $227.19 / $257.80
| Professional | | $227.19 | $227.19 | $257.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.73 / $297.08 / $1,052.97
| Professional | | $184.73 | $297.08 | $1,052.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.60 / $392.60 / $657.60
| Professional | | $392.60 | $392.60 | $657.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.16 / $381.16 / $381.16
| Facility | | $381.16 | $381.16 | $381.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.87 / $327.02 / $561.42
| Professional | | $204.87 | $327.02 | $561.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.04 / $194.04 / $301.22
| Facility | | $194.04 | $194.04 | $301.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.67 / $295.58 / $323.48
| Professional | | $192.67 | $295.58 | $323.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.00 / $4,300.00 / $10,443.12
| Facility | | $1,781.00 | $4,300.00 | $10,443.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.83 / $376.17 / $631.72
| Professional | | $275.83 | $376.17 | $631.72 |