- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,219.00 / $10,893.00
| Facility | | $803.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.32 / $868.19 / $1,332.09
| Professional | | $707.32 | $868.19 | $1,332.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,308.48 / $4,465.93 / $9,140.28
| Facility | | $2,308.48 | $4,465.93 | $9,140.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $733.09 / $927.91 / $1,234.67
| Professional | | $733.09 | $927.91 | $1,234.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $828.97 / $828.97 / $839.56
| Facility | | $828.97 | $828.97 | $839.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $868.94 / $1,076.16 / $1,575.41
| Professional | | $868.94 | $1,076.16 | $1,575.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,102.00 / $26,542.00 / $26,542.00
| Facility | | $11,102.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,762.00 / $6,896.16 / $7,991.25
| Professional | | $6,762.00 | $6,896.16 | $7,991.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $829.71 / $1,012.31 / $1,383.77
| Facility | | $829.71 | $1,012.31 | $1,383.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $917.67 / $1,468.27 / $1,835.34
| Professional | | $917.67 | $1,468.27 | $1,835.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $829.71 / $1,014.46 / $1,461.00
| Facility | | $829.71 | $1,014.46 | $1,461.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $869.92 / $1,169.19 / $1,829.90
| Professional | | $869.92 | $1,169.19 | $1,829.90 |
- 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
- $698.17 / $948.07 / $1,396.11
| Professional | | $698.17 | $948.07 | $1,396.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $783.20 / $888.52 / $1,236.76
| Professional | | $783.20 | $888.52 | $1,236.76 |