- 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
- $349.81 / $380.25 / $513.50
| Professional | | $349.81 | $380.25 | $513.50 |
- 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
- $370.14 / $384.11 / $684.80
| Professional | | $370.14 | $384.11 | $684.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.81 / $391.79 / $671.02
| Professional | | $296.81 | $391.79 | $671.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.11 / $444.11 / $572.69
| Professional | | $444.11 | $444.11 | $572.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,389.00 / $8,017.00
| Facility | | $934.00 | $3,389.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.60 / $452.35 / $2,605.00
| Professional | | $364.60 | $452.35 | $2,605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.10 / $386.10 / $386.10
| Professional | | $386.10 | $386.10 | $386.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.48 / $395.19 / $671.02
| Professional | | $300.48 | $395.19 | $671.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.07 / $364.82 / $364.82
| Facility | | $344.07 | $364.82 | $364.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.07 / $364.82 / $386.22
| Professional | | $344.07 | $364.82 | $386.22 |
- 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
- $320.68 / $409.26 / $666.82
| Professional | | $320.68 | $409.26 | $666.82 |