- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.52 / $3,839.00 / $8,247.00
| Facility | | $484.52 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.65 / $484.52 / $3,228.67
| Professional | | $407.65 | $484.52 | $3,228.67 |
- 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
- $489.96 / $576.41 / $945.01
| Professional | | $489.96 | $576.41 | $945.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.02 / $535.90 / $813.11
| Professional | | $404.02 | $535.90 | $813.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.47 / $557.47 / $850.14
| Professional | | $557.47 | $557.47 | $850.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.65 / $513.12 / $3,228.67
| Professional | | $407.65 | $513.12 | $3,228.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.10 / $398.10 / $436.00
| Professional | | $398.10 | $398.10 | $436.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.81 / $535.90 / $813.11
| Professional | | $416.81 | $535.90 | $813.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.13 / $543.13 / $623.21
| Facility | | $543.13 | $543.13 | $623.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.11 / $551.14 / $883.69
| Professional | | $213.11 | $551.14 | $883.69 |
- 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
- $373.61 / $586.77 / $1,048.83
| Professional | | $373.61 | $586.77 | $1,048.83 |