- 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
- $376.68 / $444.41 / $715.52
| Professional | | $376.68 | $444.41 | $715.52 |
- 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
- $462.29 / $479.73 / $479.73
| Professional | | $462.29 | $479.73 | $479.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $451.05 / $581.91 / $940.55
| Professional | | $451.05 | $581.91 | $940.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.13 / $760.38 / $760.38
| Professional | | $566.13 | $760.38 | $760.38 |
- 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
- $382.85 / $493.13 / $1,539.00
| Professional | | $382.85 | $493.13 | $1,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $514.70 / $1,182.40
| Professional | | $4.00 | $514.70 | $1,182.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.54 / $587.19 / $948.00
| Professional | | $449.54 | $587.19 | $948.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.74 / $456.74 / $457.70
| Facility | | $456.74 | $456.74 | $457.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.11 / $457.70 / $484.37
| Professional | | $438.11 | $457.70 | $484.37 |
- 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
- $407.66 / $540.79 / $908.50
| Professional | | $407.66 | $540.79 | $908.50 |