- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,378.00 / $3,116.00 / $10,635.00
| Facility | | $1,378.00 | $3,116.00 | $10,635.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.19 / $601.54 / $2,547.00
| Professional | | $159.19 | $601.54 | $2,547.00 |
- 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
- $7,641.05 / $60,749.39 / $72,899.27
| Facility | | $7,641.05 | $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
- $849.00 / $849.00 / $849.00
| Professional | | $849.00 | $849.00 | $849.00 |
- 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
- $849.00 / $849.00 / $849.00
| Professional | | $849.00 | $849.00 | $849.00 |
- 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
- $675.00 / $2,499.00 / $5,235.00
| Facility | | $675.00 | $2,499.00 | $5,235.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.45 / $201.45 / $201.45
| Professional | | $201.45 | $201.45 | $201.45 |