- 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
- $580.12 / $720.85 / $933.59
| Professional | | $580.12 | $720.85 | $933.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $694.23 / $720.42 / $720.42
| Professional | | $694.23 | $720.42 | $720.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $655.45 / $884.15 / $1,448.98
| Professional | | $655.45 | $884.15 | $1,448.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $830.97 / $1,102.26 / $1,116.24
| Professional | | $830.97 | $1,102.26 | $1,116.24 |
- 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
- $580.12 / $761.40 / $2,605.00
| Professional | | $580.12 | $761.40 | $2,605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $715.00 / $1,869.50
| Professional | | $6.00 | $715.00 | $1,869.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.75 / $913.58 / $1,468.36
| Professional | | $676.75 | $913.58 | $1,468.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.50 / $693.78 / $693.78
| Facility | | $650.50 | $693.78 | $693.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $650.50 / $693.78 / $739.78
| Professional | | $650.50 | $693.78 | $739.78 |
- 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
- $601.82 / $887.71 / $1,457.90
| Professional | | $601.82 | $887.71 | $1,457.90 |