- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $3,682.00 / $10,836.00
| Facility | | $714.00 | $3,682.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.51 / $639.41 / $766.00
| Professional | | $546.51 | $639.41 | $766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.90 / $1,021.41 / $6,948.22
| Facility | | $601.90 | $1,021.41 | $6,948.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.12 / $662.52 / $899.34
| Professional | | $524.12 | $662.52 | $899.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.62 / $492.62 / $492.62
| Facility | | $492.62 | $492.62 | $492.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,246.00 / $16,401.00 / $18,406.00
| Facility | | $15,246.00 | $16,401.00 | $18,406.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $587.83 / $769.34 / $1,234.02
| Professional | | $587.83 | $769.34 | $1,234.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $6,984.89
| Facility | | $55.00 | $55.00 | $6,984.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,996.00 / $4,103.84 / $4,836.38
| Professional | | $3,996.00 | $4,103.84 | $4,836.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.32 / $646.46 / $1,320.80
| Facility | | $545.32 | $646.46 | $1,320.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $714.86 / $824.84 / $962.31
| Professional | | $714.86 | $824.84 | $962.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.70 / $672.50 / $1,594.67
| Facility | | $545.70 | $672.50 | $1,594.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $587.83 / $799.43 / $1,342.25
| Professional | | $587.83 | $799.43 | $1,342.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.06 / $638.38 / $1,027.35
| Professional | | $487.06 | $638.38 | $1,027.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.31 / $538.00 / $735.47
| Professional | | $469.31 | $538.00 | $735.47 |