- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.00 / $3,213.00 / $10,836.00
| Facility | | $727.00 | $3,213.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.89 / $343.21 / $538.89
| Professional | | $299.89 | $343.21 | $538.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,091.07 / $4,396.66 / $8,375.31
| Facility | | $2,091.07 | $4,396.66 | $8,375.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.19 / $398.95 / $543.64
| Professional | | $315.19 | $398.95 | $543.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.16 / $296.16 / $296.16
| Facility | | $296.16 | $296.16 | $296.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,403.30 / $2,403.30 / $2,403.30
| Facility | | $2,403.30 | $2,403.30 | $2,403.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.28 / $450.97 / $677.88
| Professional | | $341.28 | $450.97 | $677.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,496.40 / $26,542.00 / $26,542.00
| Facility | | $9,496.40 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,629.13 / $3,629.13 / $3,629.13
| Professional | | $3,629.13 | $3,629.13 | $3,629.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.54 / $418.41 / $754.70
| Facility | | $321.54 | $418.41 | $754.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.02 / $507.27 / $596.79
| Professional | | $431.02 | $507.27 | $596.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.10 / $408.10 / $408.10
| Professional | | $408.10 | $408.10 | $408.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.54 / $425.02 / $878.69
| Facility | | $321.54 | $425.02 | $878.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.07 / $452.64 / $715.28
| Professional | | $342.07 | $452.64 | $715.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,293.00 / $7,600.00
| Facility | | $1,154.00 | $3,293.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.75 / $357.58 / $574.02
| Professional | | $263.75 | $357.58 | $574.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.97 / $321.39 / $447.01
| Professional | | $282.97 | $321.39 | $447.01 |