- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,037.00 / $9,594.00 / $15,742.00
| Facility | | $4,037.00 | $9,594.00 | $15,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,428.00 / $6,705.00 / $11,987.00
| Professional | | $2,428.00 | $6,705.00 | $11,987.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,786.00 / $13,345.00 / $14,686.00
| Facility | | $10,786.00 | $13,345.00 | $14,686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.20 / $390.23 / $439.06
| Professional | | $293.20 | $390.23 | $439.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.68 / $396.47 / $10,306.09
| Professional | | $293.68 | $396.47 | $10,306.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,122.00 / $8,122.00 / $10,523.00
| Facility | | $8,122.00 | $8,122.00 | $10,523.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.60 / $292.32 / $360.53
| Professional | | $243.60 | $292.32 | $360.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.79 / $328.02 / $459.55
| Facility | | $242.79 | $328.02 | $459.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.00 / $477.00 / $601.46
| Professional | | $329.00 | $477.00 | $601.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.68 / $344.30 / $662.03
| Facility | | $265.68 | $344.30 | $662.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.68 / $344.30 / $662.03
| Professional | | $265.68 | $344.30 | $662.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.00 / $11,671.00 / $21,639.00
| Facility | | $6,693.00 | $11,671.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.88 / $360.42 / $567.01
| Professional | | $234.88 | $360.42 | $567.01 |