- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,254.00 / $10,398.00
| Facility | | $1,013.00 | $5,254.00 | $10,398.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.45 / $689.81 / $887.75
| Professional | | $541.45 | $689.81 | $887.75 |
- 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
- $653.90 / $678.58 / $678.58
| Professional | | $653.90 | $678.58 | $678.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $569.57 / $813.14 / $1,289.35
| Professional | | $569.57 | $813.14 | $1,289.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $789.12 / $1,046.84 / $1,067.35
| Professional | | $789.12 | $1,046.84 | $1,067.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,667.69 / $39,667.69 / $39,667.69
| Facility | | $39,667.69 | $39,667.69 | $39,667.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,742.00 / $11,083.00
| Facility | | $1,301.00 | $5,742.00 | $11,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.82 / $742.23 / $3,409.96
| Professional | | $622.82 | $742.23 | $3,409.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $611.29 / $1,821.60
| Professional | | $5.00 | $611.29 | $1,821.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $624.88 / $818.44 / $1,378.60
| Professional | | $624.88 | $818.44 | $1,378.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.92 / $662.59 / $662.59
| Facility | | $558.92 | $662.59 | $662.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.92 / $662.59 / $711.35
| Professional | | $558.92 | $662.59 | $711.35 |
- 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
- $535.35 / $789.81 / $1,309.13
| Professional | | $535.35 | $789.81 | $1,309.13 |