- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,264.00 / $9,534.00
| Facility | | $832.00 | $4,264.00 | $9,534.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.14 / $604.04 / $699.84
| Professional | | $543.14 | $604.04 | $699.84 |
- 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
- $564.71 / $664.36 / $1,033.22
| Professional | | $564.71 | $664.36 | $1,033.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.53 / $842.67 / $1,285.57
| Professional | | $621.53 | $842.67 | $1,285.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.63 / $1,006.32 / $1,009.49
| Professional | | $758.63 | $1,006.32 | $1,009.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,178.06 / $27,178.06 / $27,178.06
| Facility | | $27,178.06 | $27,178.06 | $27,178.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $5,350.00 / $9,590.00
| Facility | | $1,020.00 | $5,350.00 | $9,590.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.14 / $625.29 / $1,600.85
| Professional | | $543.14 | $625.29 | $1,600.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $1,549.70
| Professional | | $5.00 | $5.00 | $1,549.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $634.16 / $842.67 / $1,478.73
| Professional | | $634.16 | $842.67 | $1,478.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.78 / $630.78 / $663.84
| Facility | | $630.78 | $630.78 | $663.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.54 / $631.79 / $666.68
| Professional | | $613.54 | $631.79 | $666.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $599.34 / $788.60 / $1,303.48
| Professional | | $599.34 | $788.60 | $1,303.48 |