- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.41 / $2,543.00 / $8,451.00
| Facility | | $602.41 | $2,543.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.98 / $564.88 / $1,039.45
| Professional | | $351.98 | $564.88 | $1,039.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $632.77 / $656.65 / $656.65
| Professional | | $632.77 | $656.65 | $656.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.05 / $626.79 / $1,051.01
| Professional | | $390.05 | $626.79 | $1,051.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $765.32 / $983.99 / $1,018.19
| Professional | | $765.32 | $983.99 | $1,018.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,374.91 / $2,740.38 / $7,599.55
| Facility | | $1,374.91 | $2,740.38 | $7,599.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.35 / $2,467.00 / $8,427.00
| Facility | | $611.35 | $2,467.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.70 / $602.99 / $1,204.89
| Professional | | $360.70 | $602.99 | $1,204.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.20 / $609.20 / $640.50
| Professional | | $609.20 | $609.20 | $640.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.00 / $704.00 / $704.00
| Facility | | $704.00 | $704.00 | $704.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.24 / $634.79 / $1,151.16
| Professional | | $399.24 | $634.79 | $1,151.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.87 / $444.84 / $685.72
| Facility | | $404.87 | $444.84 | $685.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.87 / $617.12 / $676.44
| Professional | | $404.87 | $617.12 | $676.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.00 / $3,742.00 / $9,211.81
| Facility | | $582.00 | $3,742.00 | $9,211.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.38 / $737.74 / $1,319.66
| Professional | | $578.38 | $737.74 | $1,319.66 |