- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.68 / $3,839.00 / $8,427.00
| Facility | | $472.68 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.03 / $443.85 / $598.30
| Professional | | $237.03 | $443.85 | $598.30 |
- 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
- $447.13 / $464.00 / $464.00
| Professional | | $447.13 | $464.00 | $464.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.63 / $480.49 / $752.14
| Professional | | $275.63 | $480.49 | $752.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.11 / $695.18 / $695.18
| Professional | | $524.11 | $695.18 | $695.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,427.00
| Facility | | $832.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.52 / $452.73 / $1,426.00
| Professional | | $238.52 | $452.73 | $1,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $359.00 / $1,118.00
| Professional | | $6.00 | $359.00 | $1,118.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.00 / $506.18 / $851.53
| Professional | | $282.00 | $506.18 | $851.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.13 / $439.85 / $439.85
| Facility | | $405.13 | $439.85 | $439.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.13 / $439.85 / $460.78
| Professional | | $405.13 | $439.85 | $460.78 |
- 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
- $246.69 / $473.40 / $900.31
| Professional | | $246.69 | $473.40 | $900.31 |