- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $3,839.00 / $8,113.00
| Facility | | $1,301.00 | $3,839.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,652.17 / $1,652.17 / $1,652.17
| Professional | | $1,652.17 | $1,652.17 | $1,652.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $915.39 / $949.94 / $949.94
| Professional | | $915.39 | $949.94 | $949.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $800.00 / $2,269.00
| Facility | | $500.00 | $800.00 | $2,269.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.00 / $482.72 / $595.00
| Professional | | $322.00 | $482.72 | $595.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,247.00
| Facility | | $1,013.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,544.00 / $1,652.17 / $2,577.39
| Professional | | $1,544.00 | $1,652.17 | $2,577.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $7.00 / $7.00
| Professional | | $7.00 | $7.00 | $7.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $800.00 / $2,269.00
| Facility | | $500.00 | $800.00 | $2,269.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.00 / $499.73 / $630.00
| Professional | | $329.00 | $499.73 | $630.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,705.26 / $1,705.26 / $1,705.26
| Facility | | $1,705.26 | $1,705.26 | $1,705.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,705.26 / $1,705.26 / $1,705.26
| Professional | | $1,705.26 | $1,705.26 | $1,705.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.00 / $2,020.00 / $6,322.00
| Facility | | $388.00 | $2,020.00 | $6,322.00 |