- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.92 / $574.94 / $832.38
| Professional | | $514.92 | $574.94 | $832.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $577.91 / $608.73 / $1,032.83
| Professional | | $577.91 | $608.73 | $1,032.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.05 / $655.05 / $655.05
| Facility | | $655.05 | $655.05 | $655.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.34 / $685.78 / $1,158.72
| Professional | | $517.34 | $685.78 | $1,158.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $686.09 / $929.01 / $1,185.07
| Professional | | $686.09 | $929.01 | $1,185.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,077.00 / $8,017.00
| Facility | | $954.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.92 / $634.16 / $2,850.58
| Professional | | $514.92 | $634.16 | $2,850.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $778.60 / $778.60 / $1,177.09
| Professional | | $778.60 | $778.60 | $1,177.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.05 / $655.05 / $655.05
| Facility | | $655.05 | $655.05 | $655.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.58 / $706.38 / $1,160.16
| Professional | | $521.58 | $706.38 | $1,160.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.58 / $561.58 / $614.03
| Facility | | $561.58 | $561.58 | $614.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $545.19 / $563.41 / $614.03
| Professional | | $545.19 | $563.41 | $614.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.83 / $714.23 / $1,152.66
| Professional | | $509.83 | $714.23 | $1,152.66 |