- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.27 / $5,412.00 / $18,631.00
| Facility | | $352.27 | $5,412.00 | $18,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $268.95 / $340.07 / $364.18
| Professional | | $268.95 | $340.07 | $364.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,735.00 / $16,211.00 / $19,276.00
| Facility | | $14,735.00 | $16,211.00 | $19,276.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.77 / $399.77 / $693.52
| Professional | | $399.77 | $399.77 | $693.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.19 / $751.78 / $1,362.59
| Professional | | $392.19 | $751.78 | $1,362.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.91 / $8,911.68 / $46,027.00
| Facility | | $178.91 | $8,911.68 | $46,027.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.80 / $418.44 / $765.09
| Professional | | $320.80 | $418.44 | $765.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.33 / $336.40 / $414.89
| Professional | | $280.33 | $336.40 | $414.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.43 / $427.46 / $600.17
| Facility | | $299.43 | $427.46 | $600.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.00 / $360.00 / $541.00
| Professional | | $106.00 | $360.00 | $541.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.99 / $328.08 / $705.05
| Facility | | $83.99 | $328.08 | $705.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.05 / $378.81 / $9,563.00
| Professional | | $91.05 | $378.81 | $9,563.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,695.00 / $12,803.00 / $25,050.00
| Facility | | $7,695.00 | $12,803.00 | $25,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.88 / $425.53 / $665.48
| Professional | | $286.88 | $425.53 | $665.48 |