- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,451.00
| Facility | | $832.00 | $3,839.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.41 / $543.29 / $704.82
| Professional | | $469.41 | $543.29 | $704.82 |
- 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
- $466.26 / $548.54 / $548.54
| Professional | | $466.26 | $548.54 | $548.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.02 / $673.21 / $1,093.64
| Professional | | $493.02 | $673.21 | $1,093.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.86 / $840.93 / $852.21
| Professional | | $633.86 | $840.93 | $852.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,972.51 / $7,640.64 / $18,460.50
| Facility | | $5,972.51 | $7,640.64 | $18,460.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $4,068.00 / $8,427.00
| Facility | | $954.00 | $4,068.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.20 / $580.59 / $2,805.73
| Professional | | $499.20 | $580.59 | $2,805.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $720.80 / $1,411.70
| Professional | | $6.00 | $720.80 | $1,411.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.72 / $695.64 / $1,114.84
| Professional | | $514.72 | $695.64 | $1,114.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.08 / $524.08 / $575.59
| Facility | | $524.08 | $524.08 | $575.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.48 / $524.08 / $575.59
| Professional | | $512.48 | $524.08 | $575.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,824.00 / $4,815.00
| Facility | | $1,175.00 | $2,824.00 | $4,815.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.28 / $657.05 / $1,083.08
| Professional | | $460.28 | $657.05 | $1,083.08 |