- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.26 / $4,771.00 / $9,539.00
| Facility | | $826.26 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.09 / $770.87 / $978.10
| Professional | | $660.09 | $770.87 | $978.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,142.00 / $37,782.72 / $52,623.67
| Facility | | $7,142.00 | $37,782.72 | $52,623.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.10 / $876.00 / $1,448.29
| Professional | | $683.10 | $876.00 | $1,448.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $874.11 / $874.11 / $17,559.00
| Professional | | $874.11 | $874.11 | $17,559.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $836.97
| Facility | | $640.00 | $640.00 | $836.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.64 / $939.58 / $1,606.24
| Professional | | $706.64 | $939.58 | $1,606.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.57 / $904.41 / $1,068.18
| Professional | | $706.57 | $904.41 | $1,068.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.08 / $966.72 / $1,383.55
| Facility | | $749.08 | $966.72 | $1,383.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $894.34 / $1,015.00 / $1,368.00
| Professional | | $894.34 | $1,015.00 | $1,368.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.49 / $913.88 / $3,442.00
| Facility | | $708.49 | $913.88 | $3,442.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.49 / $913.88 / $3,442.00
| Professional | | $708.49 | $913.88 | $3,442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.00 / $13,296.00 / $26,537.00
| Facility | | $7,408.00 | $13,296.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.04 / $913.59 / $1,409.39
| Professional | | $565.04 | $913.59 | $1,409.39 |