- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.39 / $3,589.00 / $8,113.00
| Facility | | $559.39 | $3,589.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.07 / $494.97 / $643.60
| Professional | | $368.07 | $494.97 | $643.60 |
- 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
- $516.92 / $536.44 / $1,044.71
| Professional | | $516.92 | $536.44 | $1,044.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.48 / $596.88 / $953.69
| Professional | | $413.48 | $596.88 | $953.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.77 / $811.60 / $832.27
| Professional | | $613.77 | $811.60 | $832.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.06 / $19,950.39 / $34,151.42
| Facility | | $4,038.06 | $19,950.39 | $34,151.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.00 / $4,311.78 / $8,240.00
| Facility | | $926.00 | $4,311.78 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.13 / $536.62 / $1,645.32
| Professional | | $386.13 | $536.62 | $1,645.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $537.00 / $1,352.50
| Professional | | $5.00 | $537.00 | $1,352.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.11 / $608.11 / $1,003.74
| Professional | | $428.11 | $608.11 | $1,003.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.78 / $411.92 / $502.57
| Facility | | $375.78 | $411.92 | $502.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.51 / $411.92 / $534.95
| Professional | | $375.51 | $411.92 | $534.95 |
- 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
- $463.95 / $672.54 / $1,155.18
| Professional | | $463.95 | $672.54 | $1,155.18 |