- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $6,962.00 / $41,453.00
| Facility | | $1,819.00 | $6,962.00 | $41,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.77 / $354.03 / $447.35
| Professional | | $311.77 | $354.03 | $447.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,448.00 / $8,782.00 / $76,745.00
| Facility | | $2,448.00 | $8,782.00 | $76,745.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.80 / $324.01 / $608.91
| Professional | | $262.80 | $324.01 | $608.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.48 / $4,243.00 / $28,291.50
| Facility | | $94.48 | $4,243.00 | $28,291.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.48 / $334.77 / $433.41
| Professional | | $94.48 | $334.77 | $433.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.95 / $20,885.00 / $31,859.00
| Facility | | $336.95 | $20,885.00 | $31,859.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.55 / $546.59 / $1,116.31
| Professional | | $339.55 | $546.59 | $1,116.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.15 / $176.47 / $610.00
| Facility | | $85.15 | $176.47 | $610.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.12 / $469.49 / $680.73
| Professional | | $352.12 | $469.49 | $680.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.89 / $464.28 / $610.41
| Professional | | $272.89 | $464.28 | $610.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.95 / $15,946.00 / $47,444.00
| Facility | | $336.95 | $15,946.00 | $47,444.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.55 / $529.87 / $1,000.37
| Professional | | $339.55 | $529.87 | $1,000.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,857.00 / $10,913.00 / $31,073.00
| Facility | | $2,857.00 | $10,913.00 | $31,073.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.38 / $442.99 / $995.37
| Professional | | $329.38 | $442.99 | $995.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.41 / $610.41 / $1,749.36
| Facility | | $610.41 | $610.41 | $1,749.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.67 / $489.65 / $849.28
| Professional | | $306.67 | $489.65 | $849.28 |