- 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
- $344.39 / $399.45 / $508.33
| Professional | | $344.39 | $399.45 | $508.33 |
- 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
- $427.57 / $443.71 / $731.09
| Professional | | $427.57 | $443.71 | $731.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.01 / $540.77 / $865.31
| Professional | | $408.01 | $540.77 | $865.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.08 / $703.76 / $703.76
| Professional | | $524.08 | $703.76 | $703.76 |
- 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
- $352.59 / $441.80 / $2,138.91
| Professional | | $352.59 | $441.80 | $2,138.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $474.20 / $1,092.40
| Professional | | $4.00 | $474.20 | $1,092.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.68 / $540.77 / $873.64
| Professional | | $406.68 | $540.77 | $873.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.95 / $420.95 / $431.86
| Facility | | $420.95 | $420.95 | $431.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.45 / $426.57 / $446.83
| Professional | | $404.45 | $426.57 | $446.83 |
- 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
- $370.52 / $492.70 / $826.88
| Professional | | $370.52 | $492.70 | $826.88 |