- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $5,079.00 / $9,534.00
| Facility | | $882.00 | $5,079.00 | $9,534.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.94 / $432.64 / $677.95
| Professional | | $377.94 | $432.64 | $677.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.60 / $603.03 / $802.96
| Professional | | $380.60 | $603.03 | $802.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.42 / $556.10 / $862.39
| Professional | | $416.42 | $556.10 | $862.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.83 / $667.97 / $673.03
| Professional | | $504.83 | $667.97 | $673.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,996.96 / $2,996.96 / $32,739.59
| Facility | | $2,996.96 | $2,996.96 | $32,739.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.00 / $5,350.00 / $9,830.00
| Facility | | $1,298.00 | $5,350.00 | $9,830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.79 / $464.76 / $2,020.00
| Professional | | $393.79 | $464.76 | $2,020.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $495.20 / $1,076.90
| Professional | | $6.00 | $495.20 | $1,076.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.41 / $562.79 / $868.22
| Professional | | $427.41 | $562.79 | $868.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.05 / $418.05 / $437.15
| Facility | | $418.05 | $418.05 | $437.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.19 / $419.24 / $438.98
| Professional | | $406.19 | $419.24 | $438.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.61 / $527.22 / $859.54
| Professional | | $390.61 | $527.22 | $859.54 |