- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $754.16 / $2,679.00 / $8,017.00
| Facility | | $754.16 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.34 / $651.17 / $937.10
| Professional | | $551.34 | $651.17 | $937.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.95 / $713.91 / $713.91
| Professional | | $687.95 | $713.91 | $713.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $959.91 / $959.91 / $959.91
| Facility | | $959.91 | $959.91 | $959.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $542.26 / $747.82 / $1,288.95
| Professional | | $542.26 | $747.82 | $1,288.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $830.25 / $1,105.60 / $1,434.06
| Professional | | $830.25 | $1,105.60 | $1,434.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $2,679.00 / $8,017.00
| Facility | | $934.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.14 / $730.24 / $2,605.00
| Professional | | $555.14 | $730.24 | $2,605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.00 / $392.00 / $1,647.30
| Professional | | $392.00 | $392.00 | $1,647.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $959.91 / $959.91 / $959.91
| Facility | | $959.91 | $959.91 | $959.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.57 / $762.06 / $1,295.00
| Professional | | $555.57 | $762.06 | $1,295.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.11 / $570.38 / $684.20
| Facility | | $430.11 | $570.38 | $684.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.06 / $614.10 / $739.39
| Professional | | $502.06 | $614.10 | $739.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $2,391.00 / $3,742.00
| Facility | | $912.00 | $2,391.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.62 / $781.79 / $1,330.07
| Professional | | $572.62 | $781.79 | $1,330.07 |