- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.98 / $3,839.00 / $8,247.00
| Facility | | $560.98 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.01 / $559.77 / $682.35
| Professional | | $497.01 | $559.77 | $682.35 |
- 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
- $391.71 / $812.06 / $1,261.54
| Professional | | $391.71 | $812.06 | $1,261.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.84 / $792.18 / $1,211.90
| Professional | | $460.84 | $792.18 | $1,211.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $671.96 / $671.96 / $708.59
| Professional | | $671.96 | $671.96 | $708.59 |
- 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
- $497.01 / $626.51 / $2,843.00
| Professional | | $497.01 | $626.51 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $793.50 / $1,338.80
| Professional | | $10.00 | $793.50 | $1,338.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.66 / $792.74 / $1,230.18
| Professional | | $498.66 | $792.74 | $1,230.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.80 / $437.80 / $594.58
| Facility | | $437.80 | $437.80 | $594.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.80 / $446.56 / $594.58
| Professional | | $417.80 | $446.56 | $594.58 |
- 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
- $577.75 / $818.20 / $1,363.93
| Professional | | $577.75 | $818.20 | $1,363.93 |