- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.24 / $10,122.46 / $27,982.24
| Facility | | $417.24 | $10,122.46 | $27,982.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.50 / $372.00 / $417.24
| Professional | | $276.50 | $372.00 | $417.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,386.21 / $21,151.89 / $40,484.32
| Facility | | $5,386.21 | $21,151.89 | $40,484.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.80 / $706.88 / $5,386.21
| Professional | | $415.80 | $706.88 | $5,386.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.45 / $639.58 / $897.12
| Professional | | $423.45 | $639.58 | $897.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.72 / $758.72 / $19,039.34
| Facility | | $391.72 | $758.72 | $19,039.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.72 / $683.02 / $859.34
| Professional | | $391.72 | $683.02 | $859.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.32 / $442.15 / $558.96
| Professional | | $75.32 | $442.15 | $558.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.07 / $573.23 / $598.98
| Facility | | $263.07 | $573.23 | $598.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.70 / $407.70 / $408.56
| Facility | | $407.70 | $407.70 | $408.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.61 / $695.17 / $837.95
| Professional | | $448.61 | $695.17 | $837.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,723.90 / $21,151.89 / $40,484.32
| Facility | | $13,723.90 | $21,151.89 | $40,484.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.80 / $587.72 / $791.64
| Professional | | $415.80 | $587.72 | $791.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $11,540.00 / $22,699.00
| Facility | | $3,028.00 | $11,540.00 | $22,699.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.45 / $566.36 / $948.18
| Professional | | $396.45 | $566.36 | $948.18 |