- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,306.00 / $9,504.00 / $11,679.00
| Facility | | $2,306.00 | $9,504.00 | $11,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.74 / $784.00 / $11,627.00
| Professional | | $533.74 | $784.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.00 / $5,208.00 / $17,584.00
| Facility | | $716.00 | $5,208.00 | $17,584.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.03
| Professional | | $0.02 | $0.02 | $0.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,638.70 / $60,749.39 / $72,899.27
| Facility | | $7,638.70 | $60,749.39 | $72,899.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75,936.74 / $75,936.74 / $78,974.21
| Professional | | $75,936.74 | $75,936.74 | $78,974.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $562.00 / $21,571.00
| Facility | | $425.00 | $562.00 | $21,571.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.00 / $385.00 / $385.00
| Professional | | $385.00 | $385.00 | $385.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $530.00 / $1,200.00
| Facility | | $425.00 | $530.00 | $1,200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.00 / $2,250.00 / $2,250.00
| Professional | | $385.00 | $2,250.00 | $2,250.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.00 / $50.00 / $60.00
| Professional | | $40.00 | $50.00 | $60.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.00 / $1,848.00 / $4,067.00
| Facility | | $487.00 | $1,848.00 | $4,067.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.44 / $133.44 / $133.44
| Professional | | $133.44 | $133.44 | $133.44 |