- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,350.00 / $9,830.00
| Facility | | $1,013.00 | $5,350.00 | $9,830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.97 / $464.42 / $664.70
| Professional | | $417.97 | $464.42 | $664.70 |
- 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
- $339.75 / $525.83 / $1,034.99
| Professional | | $339.75 | $525.83 | $1,034.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.71 / $685.36 / $1,119.36
| Professional | | $399.71 | $685.36 | $1,119.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.58 / $576.58 / $617.38
| Professional | | $576.58 | $576.58 | $617.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.00 / $5,897.00 / $10,689.00
| Facility | | $1,288.00 | $5,897.00 | $10,689.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.97 / $595.80 / $3,649.00
| Professional | | $417.97 | $595.80 | $3,649.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $939.40 / $1,312.30
| Professional | | $15.00 | $939.40 | $1,312.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.94 / $687.12 / $1,206.58
| Professional | | $428.94 | $687.12 | $1,206.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.47 / $377.47 / $610.97
| Facility | | $377.47 | $377.47 | $610.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.39 / $385.02 / $610.97
| Professional | | $358.39 | $385.02 | $610.97 |
- 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
- $394.56 / $654.63 / $876.41
| Professional | | $394.56 | $654.63 | $876.41 |