- 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
- $315.30 / $367.69 / $573.36
| Professional | | $315.30 | $367.69 | $573.36 |
- 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
- $318.51 / $503.73 / $666.29
| Professional | | $318.51 | $503.73 | $666.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.47 / $464.50 / $709.81
| Professional | | $347.47 | $464.50 | $709.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.18 / $561.55 / $565.98
| Professional | | $424.18 | $561.55 | $565.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,144.37 / $17,144.37 / $22,567.00
| Facility | | $17,144.37 | $17,144.37 | $22,567.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,314.00 / $8,017.00
| Facility | | $934.00 | $3,314.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.77 / $394.33 / $1,584.00
| Professional | | $327.77 | $394.33 | $1,584.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $407.00 / $901.50
| Professional | | $3.00 | $407.00 | $901.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.08 / $469.61 / $723.12
| Professional | | $349.08 | $469.61 | $723.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.51 / $348.51 / $374.52
| Facility | | $348.51 | $348.51 | $374.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.02 / $349.07 / $374.52
| Professional | | $339.02 | $349.07 | $374.52 |
- 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
- $327.35 / $440.99 / $729.86
| Professional | | $327.35 | $440.99 | $729.86 |