- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.00 / $2,747.00 / $8,017.00
| Facility | | $801.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.24 / $355.89 / $466.68
| Professional | | $316.24 | $355.89 | $466.68 |
- 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
- $392.88 / $407.70 / $407.70
| Professional | | $392.88 | $407.70 | $407.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.29 / $493.98 / $795.54
| Professional | | $366.29 | $493.98 | $795.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.97 / $646.59 / $646.59
| Professional | | $480.97 | $646.59 | $646.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $920.53 / $920.53 / $920.53
| Facility | | $920.53 | $920.53 | $920.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.07 / $425.00 / $1,982.14
| Professional | | $322.07 | $425.00 | $1,982.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $458.30 / $987.10
| Professional | | $4.00 | $458.30 | $987.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.29 / $493.98 / $821.08
| Professional | | $366.29 | $493.98 | $821.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.19 / $385.19 / $414.37
| Facility | | $385.19 | $385.19 | $414.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.92 / $391.54 / $414.37
| Professional | | $368.92 | $391.54 | $414.37 |
- 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
- $357.90 / $451.35 / $771.35
| Professional | | $357.90 | $451.35 | $771.35 |