- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.00 / $4,534.00 / $8,509.00
| Facility | | $926.00 | $4,534.00 | $8,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.88 / $440.25 / $612.77
| Professional | | $378.88 | $440.25 | $612.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.09 / $686.29 / $874.86
| Professional | | $432.09 | $686.29 | $874.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.02 / $558.12 / $863.87
| Professional | | $417.02 | $558.12 | $863.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.66 / $669.08 / $674.19
| Professional | | $505.66 | $669.08 | $674.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,246.29 / $13,246.29 / $13,246.29
| Facility | | $13,246.29 | $13,246.29 | $13,246.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,427.00
| Facility | | $1,013.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.68 / $463.40 / $2,272.82
| Professional | | $394.68 | $463.40 | $2,272.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $517.10 / $1,079.80
| Professional | | $6.00 | $517.10 | $1,079.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.08 / $563.60 / $871.87
| Professional | | $428.08 | $563.60 | $871.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.54 / $418.98 / $418.98
| Facility | | $400.54 | $418.98 | $418.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.54 / $418.98 / $440.03
| Professional | | $400.54 | $418.98 | $440.03 |
- 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
- $403.08 / $513.40 / $862.16
| Professional | | $403.08 | $513.40 | $862.16 |