- 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
- $472.19 / $527.37 / $750.04
| Professional | | $472.19 | $527.37 | $750.04 |
- 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
- $529.74 / $549.72 / $936.27
| Professional | | $529.74 | $549.72 | $936.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.13 / $601.13 / $601.13
| Facility | | $601.13 | $601.13 | $601.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.69 / $620.13 / $1,062.11
| Professional | | $464.69 | $620.13 | $1,062.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.90 / $852.79 / $1,088.02
| Professional | | $629.90 | $852.79 | $1,088.02 |
- 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
- $472.19 / $576.76 / $2,726.60
| Professional | | $472.19 | $576.76 | $2,726.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $1,066.50 / $1,357.90
| Professional | | $4.00 | $1,066.50 | $1,357.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.13 / $601.13 / $601.13
| Facility | | $601.13 | $601.13 | $601.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.00 / $636.05 / $1,062.11
| Professional | | $466.00 | $636.05 | $1,062.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.51 / $514.30 / $514.30
| Facility | | $440.51 | $514.30 | $514.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.51 / $514.30 / $547.54
| Professional | | $440.51 | $514.30 | $547.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.45 / $603.94 / $975.00
| Professional | | $449.45 | $603.94 | $975.00 |