- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.13 / $3,627.00 / $8,017.00
| Facility | | $434.13 | $3,627.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.83 / $357.11 / $454.42
| Professional | | $258.83 | $357.11 | $454.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.31 / $552.42 / $661.17
| Professional | | $294.31 | $552.42 | $661.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.52 / $395.98 / $653.79
| Professional | | $257.52 | $395.98 | $653.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.99 / $533.99 / $541.90
| Professional | | $533.99 | $533.99 | $541.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,602.46 / $9,602.46 / $9,602.46
| Facility | | $9,602.46 | $9,602.46 | $9,602.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.64 / $308.27 / $407.52
| Professional | | $280.64 | $308.27 | $407.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,964.00 / $8,017.00
| Facility | | $832.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.83 / $368.67 / $1,333.89
| Professional | | $258.83 | $368.67 | $1,333.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $472.40 / $930.60
| Professional | | $3.00 | $472.40 | $930.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.01 / $397.52 / $641.30
| Professional | | $281.01 | $397.52 | $641.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.84 / $292.05 / $404.00
| Facility | | $245.84 | $292.05 | $404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.84 / $292.05 / $361.40
| Professional | | $245.84 | $292.05 | $361.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.00 / $3,475.00 / $6,000.00
| Facility | | $1,440.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.30 / $433.59 / $697.90
| Professional | | $331.30 | $433.59 | $697.90 |