- 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
- $453.20 / $498.14 / $670.34
| Professional | | $453.20 | $498.14 | $670.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.62 / $504.99 / $896.39
| Professional | | $486.62 | $504.99 | $896.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.95 / $511.48 / $845.35
| Professional | | $386.95 | $511.48 | $845.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.24 / $588.24 / $758.55
| Professional | | $588.24 | $588.24 | $758.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,586.00 / $4,586.00 / $4,586.00
| Facility | | $4,586.00 | $4,586.00 | $4,586.00 |
- 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
- $475.23 / $594.40 / $2,843.00
| Professional | | $475.23 | $594.40 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.10 / $515.10 / $895.48
| Professional | | $515.10 | $515.10 | $895.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.74 / $521.85 / $845.35
| Professional | | $392.74 | $521.85 | $845.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.59 / $477.27 / $477.27
| Facility | | $440.59 | $477.27 | $477.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.59 / $477.27 / $507.16
| Professional | | $440.59 | $477.27 | $507.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,747.00 / $4,899.49 / $12,948.01
| Facility | | $1,747.00 | $4,899.49 | $12,948.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.42 / $519.15 / $881.82
| Professional | | $417.42 | $519.15 | $881.82 |