- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.91 / $8,920.00 / $32,491.00
| Facility | | $460.91 | $8,920.00 | $32,491.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.10 / $413.80 / $585.02
| Professional | | $337.10 | $413.80 | $585.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123,526.00 / $152,581.00 / $170,101.00
| Facility | | $123,526.00 | $152,581.00 | $170,101.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.46 / $420.73 / $586.41
| Professional | | $330.46 | $420.73 | $586.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.35 / $532.12 / $15,962.00
| Professional | | $384.35 | $532.12 | $15,962.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.73 / $551.79 / $832.56
| Professional | | $363.73 | $551.79 | $832.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.75 / $399.30 / $492.47
| Professional | | $332.75 | $399.30 | $492.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.34 / $507.84 / $809.27
| Facility | | $400.34 | $507.84 | $809.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.00 / $526.00 / $839.30
| Professional | | $457.00 | $526.00 | $839.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.20 / $551.71 / $27,805.00
| Facility | | $378.20 | $551.71 | $27,805.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.20 / $551.71 / $27,805.00
| Professional | | $378.20 | $551.71 | $27,805.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,405.00 / $69,183.00 / $125,655.00
| Facility | | $29,405.00 | $69,183.00 | $125,655.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.95 / $568.03 / $806.74
| Professional | | $324.95 | $568.03 | $806.74 |