- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.64 / $3,748.00 / $10,107.42
| Facility | | $414.64 | $3,748.00 | $10,107.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.50 / $302.68 / $494.13
| Professional | | $176.50 | $302.68 | $494.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.14 / $356.64 / $356.64
| Professional | | $303.14 | $356.64 | $356.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.69 / $340.43 / $588.83
| Professional | | $211.69 | $340.43 | $588.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.30 / $546.72 / $556.03
| Professional | | $412.30 | $546.72 | $556.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,422.20 / $8,040.46 / $14,660.51
| Facility | | $4,422.20 | $8,040.46 | $14,660.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.57 / $4,194.00 / $9,972.54
| Facility | | $489.57 | $4,194.00 | $9,972.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.62 / $334.43 / $700.00
| Professional | | $194.62 | $334.43 | $700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $364.80 / $994.60
| Professional | | $3.00 | $364.80 | $994.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.17 / $340.65 / $592.21
| Professional | | $214.17 | $340.65 | $592.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.91 / $217.38 / $360.21
| Facility | | $193.91 | $217.38 | $360.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.91 / $313.68 / $385.59
| Professional | | $193.91 | $313.68 | $385.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.29 / $404.85 / $670.49
| Professional | | $290.29 | $404.85 | $670.49 |