- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $878.62 / $5,412.00 / $11,425.00
| Facility | | $878.62 | $5,412.00 | $11,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.48 / $823.74 / $1,105.04
| Professional | | $715.48 | $823.74 | $1,105.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $726.10 / $937.70 / $1,550.29
| Professional | | $726.10 | $937.70 | $1,550.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $854.35 / $893.95 / $5,113.00
| Professional | | $854.35 | $893.95 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.00 / $776.00 / $896.11
| Facility | | $776.00 | $776.00 | $896.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $767.92 / $987.65 / $1,719.96
| Professional | | $767.92 | $987.65 | $1,719.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $756.56 / $968.40 / $1,143.65
| Professional | | $756.56 | $968.40 | $1,143.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.16 / $1,012.71 / $1,478.82
| Facility | | $773.16 | $1,012.71 | $1,478.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $976.00 / $1,099.00 / $1,521.00
| Professional | | $976.00 | $1,099.00 | $1,521.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.77 / $994.81 / $3,418.26
| Facility | | $717.77 | $994.81 | $3,418.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $717.77 / $994.81 / $3,418.26
| Professional | | $717.77 | $994.81 | $3,418.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,712.79 / $11,074.00 / $21,538.00
| Facility | | $5,712.79 | $11,074.00 | $21,538.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.05 / $955.38 / $1,506.76
| Professional | | $605.05 | $955.38 | $1,506.76 |