- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.43 / $3,077.00 / $8,442.01
| Facility | | $420.43 | $3,077.00 | $8,442.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.70 / $254.28 / $957.00
| Professional | | $227.70 | $254.28 | $957.00 |
- 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
- $247.41 / $256.75 / $396.92
| Professional | | $247.41 | $256.75 | $396.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.29 / $333.72 / $510.00
| Professional | | $242.29 | $333.72 | $510.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.89 / $385.97 / $385.97
| Professional | | $290.89 | $385.97 | $385.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.25 / $7,248.84 / $12,330.60
| Facility | | $1,636.25 | $7,248.84 | $12,330.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.00 / $3,615.73 / $8,442.01
| Facility | | $760.00 | $3,615.73 | $8,442.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.16 / $317.49 / $1,005.00
| Professional | | $228.16 | $317.49 | $1,005.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $355.90 / $618.70
| Professional | | $6.00 | $355.90 | $618.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.58 / $337.48 / $573.52
| Professional | | $251.58 | $337.48 | $573.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.15 / $242.15 / $368.39
| Facility | | $242.15 | $242.15 | $368.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.63 / $243.49 / $368.39
| Professional | | $234.63 | $243.49 | $368.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.72 / $289.43 / $494.10
| Professional | | $212.72 | $289.43 | $494.10 |