- 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
- $444.92 / $531.70 / $694.58
| Professional | | $444.92 | $531.70 | $694.58 |
- 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
- $580.98 / $602.90 / $894.92
| Professional | | $580.98 | $602.90 | $894.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.07 / $743.84 / $1,178.33
| Professional | | $546.07 | $743.84 | $1,178.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.94 / $955.02 / $955.02
| Professional | | $709.94 | $955.02 | $955.02 |
- 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
- $469.03 / $599.20 / $2,605.00
| Professional | | $469.03 | $599.20 | $2,605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $723.30 / $1,453.30
| Professional | | $4.00 | $723.30 | $1,453.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.07 / $733.45 / $1,230.02
| Professional | | $546.07 | $733.45 | $1,230.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.61 / $571.61 / $688.77
| Facility | | $571.61 | $571.61 | $688.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $545.91 / $582.63 / $688.77
| Professional | | $545.91 | $582.63 | $688.77 |
- 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
- $532.62 / $680.57 / $1,168.43
| Professional | | $532.62 | $680.57 | $1,168.43 |