- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.73 / $2,747.00 / $8,017.00
| Facility | | $540.73 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.20 / $448.80 / $616.87
| Professional | | $338.20 | $448.80 | $616.87 |
- 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
- $483.20 / $501.44 / $501.44
| Professional | | $483.20 | $501.44 | $501.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.24 / $506.60 / $819.15
| Professional | | $355.24 | $506.60 | $819.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.82 / $773.17 / $788.02
| Professional | | $582.82 | $773.17 | $788.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,850.20 / $6,850.20 / $6,850.20
| Facility | | $6,850.20 | $6,850.20 | $6,850.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,077.00 / $8,017.00
| Facility | | $918.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.40 / $485.98 / $1,605.96
| Professional | | $351.40 | $485.98 | $1,605.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $556.79 / $1,322.70
| Professional | | $6.00 | $556.79 | $1,322.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.69 / $533.46 / $852.58
| Professional | | $373.69 | $533.46 | $852.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.52 / $447.20 / $484.45
| Facility | | $360.52 | $447.20 | $484.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.89 / $447.20 / $519.76
| Professional | | $359.89 | $447.20 | $519.76 |
- 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
- $390.60 / $541.47 / $919.75
| Professional | | $390.60 | $541.47 | $919.75 |