- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.42 / $2,747.00 / $8,017.00
| Facility | | $669.42 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.92 / $602.22 / $833.04
| Professional | | $505.92 | $602.22 | $833.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.15 / $734.88 / $1,204.54
| Professional | | $708.15 | $734.88 | $1,204.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.16 / $701.41 / $1,199.24
| Professional | | $524.16 | $701.41 | $1,199.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $856.10 / $1,100.70 / $1,138.40
| Professional | | $856.10 | $1,100.70 | $1,138.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.41 / $634.92 / $3,141.73
| Professional | | $515.41 | $634.92 | $3,141.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.10 / $851.10 / $881.60
| Professional | | $851.10 | $851.10 | $881.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.45 / $1,005.45 / $1,005.45
| Facility | | $1,005.45 | $1,005.45 | $1,005.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.08 / $702.40 / $1,275.83
| Professional | | $544.08 | $702.40 | $1,275.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.48 / $579.91 / $701.01
| Facility | | $548.48 | $579.91 | $701.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.14 / $650.69 / $749.85
| Professional | | $564.14 | $650.69 | $749.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $608.46 / $787.42 / $1,385.72
| Professional | | $608.46 | $787.42 | $1,385.72 |