- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.02 / $6,423.00 / $17,701.00
| Facility | | $368.02 | $6,423.00 | $17,701.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.03 / $344.63 / $1,263.16
| Professional | | $182.03 | $344.63 | $1,263.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $5,863.00 / $11,400.00
| Facility | | $2,143.00 | $5,863.00 | $11,400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.65 / $425.65 / $847.94
| Professional | | $241.65 | $425.65 | $847.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $8,011.98
| Facility | | $66.00 | $100.00 | $8,011.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.00 / $370.72 / $747.18
| Professional | | $203.00 | $370.72 | $747.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.66 / $305.69 / $720.18
| Facility | | $258.66 | $305.69 | $720.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.22 / $359.14 / $908.36
| Professional | | $196.22 | $359.14 | $908.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.45 / $282.23 / $461.57
| Professional | | $197.45 | $282.23 | $461.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.92 / $353.03 / $629.41
| Professional | | $181.92 | $353.03 | $629.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $849.04 / $883.98
| Facility | | $55.00 | $849.04 | $883.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,164.00 / $2,470.64 / $2,909.78
| Professional | | $2,164.00 | $2,470.64 | $2,909.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.83 / $346.99 / $564.85
| Facility | | $210.83 | $346.99 | $564.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.00 / $386.69 / $895.51
| Professional | | $198.00 | $386.69 | $895.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.75 / $600.75 / $1,136.91
| Professional | | $600.75 | $600.75 | $1,136.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.99 / $316.10 / $466.11
| Professional | | $218.99 | $316.10 | $466.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,523.00 / $7,384.00 / $16,148.00
| Facility | | $3,523.00 | $7,384.00 | $16,148.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.72 / $401.73 / $1,170.70
| Professional | | $273.72 | $401.73 | $1,170.70 |