- 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
- $699.19 / $762.18 / $1,128.66
| Professional | | $699.19 | $762.18 | $1,128.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $784.20 / $838.41 / $1,424.33
| Professional | | $784.20 | $838.41 | $1,424.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.81 / $886.81 / $886.81
| Facility | | $886.81 | $886.81 | $886.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.52 / $922.80 / $1,508.51
| Professional | | $640.52 | $922.80 | $1,508.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $928.00 / $1,257.36 / $1,602.92
| Professional | | $928.00 | $1,257.36 | $1,602.92 |
- 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
- $700.59 / $819.48 / $3,856.92
| Professional | | $700.59 | $819.48 | $3,856.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,160.40 / $1,160.40 / $1,592.70
| Professional | | $1,160.40 | $1,160.40 | $1,592.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.81 / $886.81 / $886.81
| Facility | | $886.81 | $886.81 | $886.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $674.76 / $934.85 / $1,540.52
| Professional | | $674.76 | $934.85 | $1,540.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.64 / $762.64 / $995.33
| Facility | | $762.64 | $762.64 | $995.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $739.13 / $766.45 / $863.64
| Professional | | $739.13 | $766.45 | $863.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.17 / $948.61 / $1,549.36
| Professional | | $675.17 | $948.61 | $1,549.36 |