- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $4,304.00 / $8,240.00
| Facility | | $882.00 | $4,304.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.78 / $225.87 / $286.76
| Professional | | $193.78 | $225.87 | $286.76 |
- 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
- $240.20 / $249.26 / $249.26
| Professional | | $240.20 | $249.26 | $249.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.53 / $323.29 / $483.37
| Professional | | $236.53 | $323.29 | $483.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.42 / $395.12 / $395.12
| Professional | | $293.42 | $395.12 | $395.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,845.85 / $8,845.85 / $8,845.85
| Facility | | $8,845.85 | $8,845.85 | $8,845.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,247.00
| Facility | | $1,013.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.62 / $242.09 / $1,228.07
| Professional | | $196.62 | $242.09 | $1,228.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $322.80 / $592.60
| Professional | | $6.00 | $322.80 | $592.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.06 / $323.29 / $524.85
| Professional | | $240.06 | $323.29 | $524.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.44 / $235.44 / $304.11
| Facility | | $235.44 | $235.44 | $304.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.34 / $240.51 / $304.11
| Professional | | $224.34 | $240.51 | $304.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.18 / $297.48 / $489.44
| Professional | | $228.18 | $297.48 | $489.44 |