- 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
- $284.55 / $332.97 / $526.33
| Professional | | $284.55 | $332.97 | $526.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.19 / $589.19 / $589.19
| Professional | | $589.19 | $589.19 | $589.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.40 / $349.10 / $349.10
| Professional | | $336.40 | $349.10 | $349.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.27 / $433.48 / $683.41
| Professional | | $321.27 | $433.48 | $683.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.28 / $530.69 / $530.69
| Professional | | $399.28 | $530.69 | $530.69 |
- 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
- $291.43 / $374.67 / $901.60
| Professional | | $291.43 | $374.67 | $901.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $300.50 / $862.80
| Professional | | $6.00 | $300.50 | $862.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.29 / $434.04 / $714.66
| Professional | | $344.29 | $434.04 | $714.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.09 / $332.09 / $347.73
| Facility | | $332.09 | $332.09 | $347.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.73 / $333.94 / $350.23
| Professional | | $321.73 | $333.94 | $350.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.43 / $434.78 / $654.29
| Professional | | $313.43 | $434.78 | $654.29 |