- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.78 / $3,964.00 / $8,451.00
| Facility | | $336.78 | $3,964.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.66 / $304.89 / $411.73
| Professional | | $254.66 | $304.89 | $411.73 |
- 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
- $238.00 / $290.56 / $290.56
| Professional | | $238.00 | $290.56 | $290.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.81 / $365.72 / $565.16
| Professional | | $281.81 | $365.72 | $565.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.91 / $423.91 / $450.31
| Professional | | $423.91 | $423.91 | $450.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $5,342.00 / $8,990.00
| Facility | | $832.00 | $5,342.00 | $8,990.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.76 / $318.86 / $1,449.88
| Professional | | $270.76 | $318.86 | $1,449.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.20 / $496.50 / $690.40
| Professional | | $391.20 | $496.50 | $690.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.57 / $365.72 / $609.05
| Professional | | $290.57 | $365.72 | $609.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.94 / $274.94 / $377.16
| Facility | | $274.94 | $274.94 | $377.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.04 / $280.44 / $377.16
| Professional | | $262.04 | $280.44 | $377.16 |
- 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
- $277.36 / $363.47 / $569.16
| Professional | | $277.36 | $363.47 | $569.16 |