- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $3,219.00 / $10,893.00
| Facility | | $767.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.86 / $738.80 / $1,273.65
| Professional | | $601.86 | $738.80 | $1,273.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,901.49 / $3,640.66 / $6,972.95
| Facility | | $1,901.49 | $3,640.66 | $6,972.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.76 / $793.52 / $1,267.26
| Professional | | $627.76 | $793.52 | $1,267.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.83 / $709.83 / $718.76
| Facility | | $709.83 | $709.83 | $718.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $729.21 / $908.27 / $1,414.05
| Professional | | $729.21 | $908.27 | $1,414.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,817.20 / $26,542.00 / $26,542.00
| Facility | | $6,817.20 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,777.04 / $5,884.96 / $6,828.60
| Professional | | $5,777.04 | $5,884.96 | $6,828.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.09 / $852.23 / $1,177.55
| Facility | | $706.09 | $852.23 | $1,177.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $784.08 / $1,254.53 / $1,568.16
| Professional | | $784.08 | $1,254.53 | $1,568.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.09 / $857.71 / $1,222.65
| Facility | | $706.09 | $857.71 | $1,222.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $747.93 / $967.83 / $1,549.71
| Professional | | $747.93 | $967.83 | $1,549.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,063.00 / $4,554.00
| Facility | | $597.00 | $2,063.00 | $4,554.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $606.20 / $782.06 / $1,173.88
| Professional | | $606.20 | $782.06 | $1,173.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $669.19 / $759.14 / $1,056.70
| Professional | | $669.19 | $759.14 | $1,056.70 |