- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.00 / $2,236.00 / $7,513.00
| Facility | | $632.00 | $2,236.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.70 / $696.56 / $1,077.15
| Professional | | $603.70 | $696.56 | $1,077.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $632.53 / $800.63 / $1,091.00
| Professional | | $632.53 | $800.63 | $1,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $584.08 / $604.90
| Facility | | $80.00 | $584.08 | $604.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $782.81 / $782.81 / $782.81
| Facility | | $782.81 | $782.81 | $782.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $674.62 / $879.27 / $1,360.06
| Professional | | $674.62 | $879.27 | $1,360.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,000.00 / $3,328.61
| Facility | | $55.00 | $2,000.00 | $3,328.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,902.56 / $5,012.24 / $5,848.88
| Professional | | $4,902.56 | $5,012.24 | $5,848.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.92 / $750.74 / $1,415.00
| Facility | | $608.92 | $750.74 | $1,415.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $836.56 / $1,003.88 / $1,244.81
| Professional | | $836.56 | $1,003.88 | $1,244.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.77 / $1,154.59 / $2,366.26
| Professional | | $709.77 | $1,154.59 | $2,366.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.92 / $765.20 / $1,438.98
| Facility | | $608.92 | $765.20 | $1,438.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.16 / $919.64 / $1,387.66
| Professional | | $675.16 | $919.64 | $1,387.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $950.00 / $2,405.00
| Facility | | $161.00 | $950.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.91 / $714.06 / $1,149.24
| Professional | | $539.91 | $714.06 | $1,149.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.17 / $652.82 / $898.10
| Professional | | $571.17 | $652.82 | $898.10 |