- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.31 / $561.64 / $768.43
| Professional | | $510.31 | $561.64 | $768.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.29 / $592.85 / $1,016.39
| Professional | | $571.29 | $592.85 | $1,016.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.62 / $647.62 / $647.62
| Facility | | $647.62 | $647.62 | $647.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.29 / $672.36 / $1,146.29
| Professional | | $481.29 | $672.36 | $1,146.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.28 / $918.22 / $1,171.58
| Professional | | $678.28 | $918.22 | $1,171.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,077.00 / $8,017.00
| Facility | | $954.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.31 / $625.20 / $2,843.00
| Professional | | $510.31 | $625.20 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $1,153.00 / $1,463.20
| Professional | | $4.00 | $1,153.00 | $1,463.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.62 / $647.62 / $647.62
| Facility | | $647.62 | $647.62 | $647.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.60 / $672.94 / $1,150.07
| Professional | | $488.60 | $672.94 | $1,150.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.27 / $555.66 / $555.66
| Facility | | $483.27 | $555.66 | $555.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $483.27 / $555.66 / $590.97
| Professional | | $483.27 | $555.66 | $590.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.00 / $2,113.00 / $3,905.54
| Facility | | $859.00 | $2,113.00 | $3,905.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.99 / $651.17 / $1,103.66
| Professional | | $479.99 | $651.17 | $1,103.66 |