- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $3,224.00 / $11,453.00
| Facility | | $767.00 | $3,224.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.60 / $378.69 / $1,479.41
| Professional | | $359.60 | $378.69 | $1,479.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,819.57 / $4,982.16 / $10,867.68
| Facility | | $2,819.57 | $4,982.16 | $10,867.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.01 / $476.01 / $476.01
| Professional | | $476.01 | $476.01 | $476.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.36 / $587.36 / $587.36
| Facility | | $587.36 | $587.36 | $587.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,460.27 / $2,460.27 / $2,460.27
| Professional | | $2,460.27 | $2,460.27 | $2,460.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,658.16 / $7,817.95 / $8,957.00
| Facility | | $1,658.16 | $7,817.95 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,093.20 / $3,367.28 / $4,476.00
| Professional | | $3,093.20 | $3,367.28 | $4,476.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.28 / $545.75 / $834.58
| Facility | | $366.28 | $545.75 | $834.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.50 / $422.55 / $6,634.00
| Professional | | $401.50 | $422.55 | $6,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.03 / $549.32 / $836.17
| Facility | | $364.03 | $549.32 | $836.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.55 / $507.36 / $2,460.27
| Professional | | $422.55 | $507.36 | $2,460.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.81 / $424.41 / $672.83
| Professional | | $320.81 | $424.41 | $672.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.16 / $561.05 / $787.59
| Professional | | $430.16 | $561.05 | $787.59 |