- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.00 / $3,627.00 / $8,017.00
| Facility | | $749.00 | $3,627.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.49 / $1,015.27 / $1,505.53
| Professional | | $197.49 | $1,015.27 | $1,505.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,015.58 / $1,892.23 / $2,203.80
| Professional | | $1,015.58 | $1,892.23 | $2,203.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.82 / $480.93 / $2,179.23
| Professional | | $235.82 | $480.93 | $2,179.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,416.70 / $1,879.23 / $1,950.41
| Professional | | $1,416.70 | $1,879.23 | $1,950.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.04 / $761.01 / $2,498.07
| Facility | | $567.04 | $761.01 | $2,498.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,964.00 / $8,247.00
| Facility | | $768.00 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.18 / $1,015.27 / $2,152.77
| Professional | | $213.18 | $1,015.27 | $2,152.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,387.10 / $3,608.80
| Professional | | $3.00 | $1,387.10 | $3,608.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.21 / $483.13 / $2,176.09
| Professional | | $236.21 | $483.13 | $2,176.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.15 / $252.71 / $1,288.91
| Facility | | $202.15 | $252.71 | $1,288.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.15 / $1,194.91 / $1,327.19
| Professional | | $202.15 | $1,194.91 | $1,327.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,199.63 / $1,597.60 / $2,638.30
| Professional | | $1,199.63 | $1,597.60 | $2,638.30 |