- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.97 / $3,839.00 / $8,427.00
| Facility | | $679.97 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.22 / $635.04 / $796.89
| Professional | | $534.22 | $635.04 | $796.89 |
- 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
- $500.33 / $588.62 / $913.84
| Professional | | $500.33 | $588.62 | $913.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.33 / $769.96 / $1,182.75
| Professional | | $558.33 | $769.96 | $1,182.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $863.58 / $863.58 / $906.15
| Professional | | $863.58 | $863.58 | $906.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,451.00
| Facility | | $832.00 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.22 / $680.62 / $1,426.00
| Professional | | $534.22 | $680.62 | $1,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,408.20 / $1,408.20 / $1,408.20
| Professional | | $1,408.20 | $1,408.20 | $1,408.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.38 / $801.88 / $1,244.59
| Professional | | $615.38 | $801.88 | $1,244.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.90 / $557.90 / $623.90
| Facility | | $557.90 | $557.90 | $623.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.38 / $568.25 / $623.90
| Professional | | $533.38 | $568.25 | $623.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,322.00
| Facility | | $656.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.24 / $766.08 / $1,151.22
| Professional | | $576.24 | $766.08 | $1,151.22 |