- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,676.00 / $8,247.00
| Facility | | $657.00 | $4,676.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.92 / $436.20 / $1,088.00
| Professional | | $242.92 | $436.20 | $1,088.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.37 / $692.91 / $812.24
| Professional | | $480.37 | $692.91 | $812.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.97 / $550.24 / $962.13
| Professional | | $415.97 | $550.24 | $962.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.52 / $739.95 / $765.92
| Professional | | $575.52 | $739.95 | $765.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.25 / $4,312.60 / $20,543.59
| Facility | | $418.25 | $4,312.60 | $20,543.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.15 / $4,761.00 / $8,247.00
| Facility | | $708.15 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.01 / $495.90 / $1,426.00
| Professional | | $246.01 | $495.90 | $1,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.10 / $534.10 / $550.40
| Professional | | $534.10 | $534.10 | $550.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $542.73 / $542.73 / $542.73
| Facility | | $542.73 | $542.73 | $542.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.09 / $556.92 / $1,008.32
| Professional | | $446.09 | $556.92 | $1,008.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.98 / $468.98 / $533.29
| Facility | | $468.98 | $468.98 | $533.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.98 / $471.09 / $533.29
| Professional | | $468.98 | $471.09 | $533.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.84 / $534.62 / $957.21
| Professional | | $414.84 | $534.62 | $957.21 |