- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.32 / $425.25 / $526.07
| Professional | | $347.32 | $425.25 | $526.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $57,255.43
| Facility | | $13,531.00 | $27,840.00 | $57,255.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.68 / $607.88 / $772.83
| Professional | | $323.68 | $607.88 | $772.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.80 / $526.34 / $786.75
| Professional | | $380.80 | $526.34 | $786.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.65 / $568.65 / $589.19
| Professional | | $568.65 | $568.65 | $589.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.91 / $482.60 / $2,193.54
| Professional | | $395.91 | $482.60 | $2,193.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $688.00 / $966.50
| Professional | | $7.00 | $688.00 | $966.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.88 / $526.96 / $835.90
| Professional | | $404.88 | $526.96 | $835.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.94 / $371.11 / $371.11
| Facility | | $353.94 | $371.11 | $371.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.94 / $371.11 / $391.14
| Professional | | $353.94 | $371.11 | $391.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,742.00 / $13,770.00 / $89,553.00
| Facility | | $3,742.00 | $13,770.00 | $89,553.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.39 / $483.22 / $769.84
| Professional | | $372.39 | $483.22 | $769.84 |