- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.25 / $391.55 / $498.09
| Professional | | $347.25 | $391.55 | $498.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.26 / $409.13 / $409.13
| Professional | | $394.26 | $409.13 | $409.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.67 / $509.03 / $796.24
| Professional | | $379.67 | $509.03 | $796.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.71 / $611.09 / $615.16
| Professional | | $461.71 | $611.09 | $615.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,911.09 / $19,911.09 / $19,911.09
| Facility | | $19,911.09 | $19,911.09 | $19,911.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.25 / $421.64 / $2,072.17
| Professional | | $347.25 | $421.64 | $2,072.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $744.20 / $981.80
| Professional | | $3.00 | $744.20 | $981.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.76 / $513.13 / $851.88
| Professional | | $386.76 | $513.13 | $851.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.86 / $381.86 / $758.40
| Facility | | $381.86 | $381.86 | $758.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.02 / $382.95 / $758.40
| Professional | | $371.02 | $382.95 | $758.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.78 / $485.06 / $786.43
| Professional | | $389.78 | $485.06 | $786.43 |