- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,981.07 / $8,317.64
| Facility | | $954.99 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $489.78 / $1,023.29
| Professional | | $234.42 | $489.78 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Professional | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $478.63 / $1,000.00
| Professional | | $245.47 | $478.63 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $812.83 / $891.25
| Professional | | $630.96 | $812.83 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $707.95 / $1,071.52
| Professional | | $269.15 | $707.95 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $5,370.32 / $7,413.10
| Facility | | $3,162.28 | $5,370.32 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,691.53 / $8,317.64
| Facility | | $912.01 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $537.03 / $1,288.25
| Professional | | $245.47 | $537.03 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $1,174.90
| Facility | | $512.86 | $512.86 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $851.14 / $1,096.48
| Professional | | $489.78 | $851.14 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $512.86 / $776.25
| Facility | | $239.88 | $512.86 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $416.87 / $562.34
| Professional | | $239.88 | $416.87 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,311.31 / $6,606.93
| Facility | | $1,348.96 | $3,311.31 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $467.74 / $891.25
| Professional | | $251.19 | $467.74 | $891.25 |