- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.87 / $2,747.00 / $8,247.00
| Facility | | $764.87 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.65 / $735.54 / $1,080.69
| Professional | | $661.65 | $735.54 | $1,080.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $740.36 / $790.98 / $1,340.53
| Professional | | $740.36 | $790.98 | $1,340.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.97 / $836.97 / $836.97
| Facility | | $836.97 | $836.97 | $836.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.88 / $886.97 / $1,475.04
| Professional | | $662.88 | $886.97 | $1,475.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $875.93 / $1,187.72 / $1,512.97
| Professional | | $875.93 | $1,187.72 | $1,512.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,427.00
| Facility | | $832.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.65 / $765.98 / $3,639.60
| Professional | | $661.65 | $765.98 | $3,639.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $952.80 / $952.80 / $1,503.00
| Professional | | $952.80 | $952.80 | $1,503.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.97 / $836.97 / $836.97
| Facility | | $836.97 | $836.97 | $836.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.88 / $907.99 / $1,486.25
| Professional | | $662.88 | $907.99 | $1,486.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.18 / $720.18 / $870.55
| Facility | | $720.18 | $720.18 | $870.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $697.80 / $723.96 / $870.55
| Professional | | $697.80 | $723.96 | $870.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $646.35 / $887.79 / $1,368.56
| Professional | | $646.35 | $887.79 | $1,368.56 |