- 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
- $379.32 / $443.53 / $589.26
| Professional | | $379.32 | $443.53 | $589.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.79 / $480.61 / $777.81
| Professional | | $460.79 | $480.61 | $777.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.39 / $523.39 / $523.39
| Facility | | $523.39 | $523.39 | $523.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.70 / $536.86 / $897.93
| Professional | | $392.70 | $536.86 | $897.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.59 / $742.37 / $947.57
| Professional | | $548.59 | $742.37 | $947.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.09 / $475.37 / $2,372.02
| Professional | | $393.09 | $475.37 | $2,372.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $726.50 / $726.50 / $939.80
| Professional | | $726.50 | $726.50 | $939.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.39 / $523.39 / $523.39
| Facility | | $523.39 | $523.39 | $523.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.34 / $543.05 / $904.42
| Professional | | $395.34 | $543.05 | $904.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.06 / $447.06 / $714.87
| Facility | | $447.06 | $447.06 | $714.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.67 / $447.83 / $476.43
| Professional | | $434.67 | $447.83 | $476.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.28 / $541.22 / $885.04
| Professional | | $385.28 | $541.22 | $885.04 |