- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,838.00 / $8,017.00
| Facility | | $768.00 | $3,838.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $483.33 / $537.04 / $621.45
| Professional | | $483.33 | $537.04 | $621.45 |
- 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
- $394.38 / $716.22 / $929.63
| Professional | | $394.38 | $716.22 | $929.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.18 / $639.64 / $927.35
| Professional | | $446.18 | $639.64 | $927.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.71 / $691.71 / $717.67
| Professional | | $691.71 | $691.71 | $717.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $4,068.00 / $8,017.00
| Facility | | $954.00 | $4,068.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.61 / $547.89 / $2,339.69
| Professional | | $442.61 | $547.89 | $2,339.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $7.00 / $1,128.80
| Professional | | $7.00 | $7.00 | $1,128.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.14 / $653.01 / $1,038.06
| Professional | | $502.14 | $653.01 | $1,038.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.25 / $437.25 / $549.16
| Facility | | $437.25 | $437.25 | $549.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.03 / $443.29 / $549.16
| Professional | | $420.03 | $443.29 | $549.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $8,538.00 / $89,553.00
| Facility | | $3,340.00 | $8,538.00 | $89,553.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.21 / $610.38 / $989.44
| Professional | | $459.21 | $610.38 | $989.44 |