- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $4,761.00 / $8,451.00
| Facility | | $921.00 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.85 / $753.86 / $975.99
| Professional | | $601.85 | $753.86 | $975.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.72 / $752.07 / $752.07
| Professional | | $724.72 | $752.07 | $752.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.97 / $899.84 / $1,442.28
| Professional | | $637.97 | $899.84 | $1,442.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.33 / $1,154.69 / $1,171.56
| Professional | | $870.33 | $1,154.69 | $1,171.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,151.42 / $34,151.42 / $34,151.42
| Facility | | $34,151.42 | $34,151.42 | $34,151.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,342.00 / $9,617.00
| Facility | | $1,054.00 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $681.11 / $776.80 / $2,843.00
| Professional | | $681.11 | $776.80 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $693.80 / $1,967.70
| Professional | | $5.00 | $693.80 | $1,967.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.94 / $903.01 / $1,519.50
| Professional | | $683.94 | $903.01 | $1,519.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.09 / $726.43 / $726.43
| Facility | | $625.09 | $726.43 | $726.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.09 / $726.43 / $776.47
| Professional | | $625.09 | $726.43 | $776.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.46 / $850.25 / $1,388.65
| Professional | | $568.46 | $850.25 | $1,388.65 |