- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,104.00
| Facility | | $832.00 | $2,747.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.44 / $416.18 / $522.63
| Professional | | $368.44 | $416.18 | $522.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.59 / $490.11 / $764.42
| Professional | | $416.59 | $490.11 | $764.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.94 / $579.21 / $884.73
| Professional | | $435.94 | $579.21 | $884.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $561.84 / $745.13 / $751.25
| Professional | | $561.84 | $745.13 | $751.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,789.09 / $7,789.09 / $10,409.61
| Facility | | $7,789.09 | $7,789.09 | $10,409.61 |
- 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
- $368.44 / $439.26 / $1,544.00
| Professional | | $368.44 | $439.26 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $1,064.09
| Professional | | $5.00 | $5.00 | $1,064.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.54 / $584.11 / $1,001.81
| Professional | | $441.54 | $584.11 | $1,001.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.32 / $466.68 / $466.68
| Facility | | $450.32 | $466.68 | $466.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.32 / $466.68 / $495.11
| Professional | | $450.32 | $466.68 | $495.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.00 / $3,475.00 / $6,000.00
| Facility | | $2,222.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.42 / $526.65 / $848.11
| Professional | | $406.42 | $526.65 | $848.11 |