- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $754.25 / $3,645.00 / $8,294.00
| Facility | | $754.25 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.50 / $459.41 / $584.48
| Professional | | $359.50 | $459.41 | $584.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,545.00 / $31,808.00 / $34,111.00
| Facility | | $24,545.00 | $31,808.00 | $34,111.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.44 / $525.04 / $868.06
| Professional | | $405.44 | $525.04 | $868.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.06 / $480.68 / $7,257.00
| Professional | | $435.06 | $480.68 | $7,257.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.69 / $500.69 / $572.00
| Facility | | $500.69 | $500.69 | $572.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.70 / $497.70 / $964.86
| Professional | | $383.70 | $497.70 | $964.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.21 / $545.09 / $644.20
| Professional | | $421.21 | $545.09 | $644.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.42 / $546.70 / $840.72
| Facility | | $420.42 | $546.70 | $840.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.15 / $577.00 / $807.00
| Professional | | $469.15 | $577.00 | $807.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.38 / $520.09 / $1,997.25
| Facility | | $391.38 | $520.09 | $1,997.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.38 / $520.09 / $1,997.25
| Professional | | $391.38 | $520.09 | $1,997.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,341.00 / $40,200.00 / $81,661.00
| Facility | | $16,341.00 | $40,200.00 | $81,661.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.45 / $480.01 / $813.65
| Professional | | $305.45 | $480.01 | $813.65 |