- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.53 / $3,839.00 / $8,247.00
| Facility | | $352.53 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.72 / $344.53 / $445.33
| Professional | | $302.72 | $344.53 | $445.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.39 / $474.29 / $651.80
| Professional | | $293.39 | $474.29 | $651.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.61 / $438.45 / $702.67
| Professional | | $330.61 | $438.45 | $702.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.24 / $494.63 / $502.82
| Professional | | $376.24 | $494.63 | $502.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,116.15 / $15,321.12 / $17,276.30
| Facility | | $14,116.15 | $15,321.12 | $17,276.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.72 / $360.77 / $4,316.00
| Professional | | $302.72 | $360.77 | $4,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $402.40 / $833.10
| Professional | | $6.00 | $402.40 | $833.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.15 / $450.06 / $734.03
| Professional | | $345.15 | $450.06 | $734.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.14 / $328.14 / $364.50
| Facility | | $328.14 | $328.14 | $364.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.36 / $329.70 / $364.50
| Professional | | $318.36 | $329.70 | $364.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.20 / $454.75 / $729.43
| Professional | | $313.20 | $454.75 | $729.43 |