- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.36 / $903.00 / $7,362.00
| Facility | | $308.36 | $903.00 | $7,362.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.36 / $322.92 / $571.69
| Professional | | $308.36 | $322.92 | $571.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,722.90 / $23,722.90 / $33,897.05
| Facility | | $23,722.90 | $23,722.90 | $33,897.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.89 / $476.09 / $874.76
| Professional | | $277.89 | $476.09 | $874.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $34,664.37
| Facility | | $395.75 | $395.75 | $34,664.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.85 / $433.52 / $752.23
| Professional | | $332.85 | $433.52 | $752.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.36 / $391.00 / $609.60
| Facility | | $308.36 | $391.00 | $609.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.59 / $375.00 / $405.00
| Professional | | $373.59 | $375.00 | $405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $413.40 / $810.30
| Professional | | $4.00 | $413.40 | $810.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,153.00 / $21,463.00 / $29,047.00
| Facility | | $8,153.00 | $21,463.00 | $29,047.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.49 / $391.43 / $734.30
| Professional | | $259.49 | $391.43 | $734.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,478.35 / $99,991.46 / $114,559.55
| Facility | | $1,478.35 | $99,991.46 | $114,559.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,740.05 / $8,263.84 / $8,263.84
| Professional | | $2,740.05 | $8,263.84 | $8,263.84 |