- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.33 / $1,245.00 / $8,413.00
| Facility | | $606.33 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.39 / $638.87 / $1,134.70
| Professional | | $523.39 | $638.87 | $1,134.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,665.09 / $3,665.09 / $3,718.57
| Facility | | $3,665.09 | $3,665.09 | $3,718.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $736.76 / $994.19 / $1,681.24
| Professional | | $736.76 | $994.19 | $1,681.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.30 / $915.03 / $1,508.50
| Professional | | $680.30 | $915.03 | $1,508.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.33 / $876.63 / $1,370.31
| Facility | | $606.33 | $876.63 | $1,370.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $645.00 / $809.00
| Professional | | $579.00 | $645.00 | $809.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $824.80 / $1,626.40
| Professional | | $3.00 | $824.80 | $1,626.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,020.00 / $10,968.00 / $17,964.00
| Facility | | $5,020.00 | $10,968.00 | $17,964.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.62 / $770.21 / $1,461.00
| Professional | | $513.62 | $770.21 | $1,461.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,341.60 / $8,957.00 / $26,542.00
| Facility | | $2,341.60 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,110.01 / $5,110.01 / $5,392.95
| Professional | | $5,110.01 | $5,110.01 | $5,392.95 |