- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.98 / $613.72 / $799.72
| Professional | | $501.98 | $613.72 | $799.72 |
- 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
- $594.16 / $616.58 / $616.58
| Professional | | $594.16 | $616.58 | $616.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.29 / $740.71 / $1,191.05
| Professional | | $526.29 | $740.71 | $1,191.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.47 / $941.12 / $950.79
| Professional | | $709.47 | $941.12 | $950.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.00 / $653.16 / $2,843.00
| Professional | | $533.00 | $653.16 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $663.20 / $1,582.30
| Professional | | $5.00 | $663.20 | $1,582.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.46 / $757.35 / $1,230.34
| Professional | | $581.46 | $757.35 | $1,230.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.90 / $593.55 / $593.55
| Facility | | $526.90 | $593.55 | $593.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.90 / $593.55 / $631.62
| Professional | | $526.90 | $593.55 | $631.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,476.00 / $10,130.54
| Facility | | $2,332.00 | $4,476.00 | $10,130.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.91 / $672.05 / $1,199.52
| Professional | | $499.91 | $672.05 | $1,199.52 |