- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.66 / $3,627.00 / $8,017.00
| Facility | | $552.66 | $3,627.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.06 / $360.49 / $460.49
| Professional | | $313.06 | $360.49 | $460.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.72 / $680.72 / $680.72
| Professional | | $680.72 | $680.72 | $680.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,800.00 / $11,479.00 / $17,952.00
| Facility | | $5,800.00 | $11,479.00 | $17,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.34 / $385.35 / $385.35
| Professional | | $371.34 | $385.35 | $385.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.21 / $472.94 / $749.97
| Professional | | $354.21 | $472.94 | $749.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.71 / $585.88 / $585.88
| Professional | | $440.71 | $585.88 | $585.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,603.47 / $11,603.47 / $11,603.47
| Facility | | $11,603.47 | $11,603.47 | $11,603.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.00 / $3,838.00 / $8,017.00
| Facility | | $655.00 | $3,838.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.68 / $375.31 / $1,119.00
| Professional | | $322.68 | $375.31 | $1,119.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $473.80 / $946.50
| Professional | | $6.00 | $473.80 | $946.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.16 / $480.74 / $784.37
| Professional | | $373.16 | $480.74 | $784.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.01 / $366.01 / $376.25
| Facility | | $366.01 | $366.01 | $376.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.52 / $368.11 / $385.72
| Professional | | $354.52 | $368.11 | $385.72 |
- 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
- $337.31 / $459.55 / $723.38
| Professional | | $337.31 | $459.55 | $723.38 |