- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.25 / $3,494.00 / $8,017.00
| Facility | | $436.25 | $3,494.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.92 / $405.09 / $739.28
| Professional | | $274.92 | $405.09 | $739.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.32 / $569.49 / $826.39
| Professional | | $391.32 | $569.49 | $826.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.50 / $475.00 / $839.72
| Professional | | $308.50 | $475.00 | $839.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.20 / $725.91 / $725.91
| Professional | | $544.20 | $725.91 | $725.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,773.80 / $5,773.80 / $10,816.09
| Facility | | $5,773.80 | $5,773.80 | $10,816.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.69 / $395.69 / $395.69
| Professional | | $395.69 | $395.69 | $395.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,839.00 / $8,017.00
| Facility | | $741.31 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.98 / $431.36 / $1,119.00
| Professional | | $280.98 | $431.36 | $1,119.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $465.90 / $1,242.00
| Professional | | $3.00 | $465.90 | $1,242.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.20 / $496.42 / $839.72
| Professional | | $312.20 | $496.42 | $839.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.02 / $314.14 / $571.32
| Facility | | $289.02 | $314.14 | $571.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.43 / $436.62 / $481.18
| Professional | | $304.43 | $436.62 | $481.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.72 / $529.44 / $899.89
| Professional | | $365.72 | $529.44 | $899.89 |