- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.23 / $2,679.00 / $8,017.00
| Facility | | $581.23 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.19 / $511.02 / $889.97
| Professional | | $341.19 | $511.02 | $889.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,404.00 / $4,354.00 / $8,639.91
| Facility | | $2,404.00 | $4,354.00 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.52 / $626.29 / $1,022.04
| Professional | | $603.52 | $626.29 | $1,022.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.73 / $683.73 / $683.73
| Facility | | $683.73 | $683.73 | $683.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.95 / $569.36 / $991.77
| Professional | | $370.95 | $569.36 | $991.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.34 / $981.01 / $1,258.05
| Professional | | $728.34 | $981.01 | $1,258.05 |
- 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
- $359.34 / $565.80 / $1,474.18
| Professional | | $359.34 | $565.80 | $1,474.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.60 / $551.60 / $1,206.30
| Professional | | $551.60 | $551.60 | $1,206.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.73 / $683.73 / $683.73
| Facility | | $683.73 | $683.73 | $683.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.22 / $587.47 / $1,004.48
| Professional | | $375.22 | $587.47 | $1,004.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.41 / $427.17 / $536.71
| Facility | | $360.41 | $427.17 | $536.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.41 / $522.87 / $574.66
| Professional | | $360.41 | $522.87 | $574.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.05 / $656.48 / $1,042.09
| Professional | | $493.05 | $656.48 | $1,042.09 |