- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $931.07 / $3,839.00 / $8,247.00
| Facility | | $931.07 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $835.45 / $928.28 / $1,083.79
| Professional | | $835.45 | $928.28 | $1,083.79 |
- 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
- $772.71 / $801.87 / $1,183.95
| Professional | | $772.71 | $801.87 | $1,183.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $765.42 / $1,048.06 / $1,724.55
| Professional | | $765.42 | $1,048.06 | $1,724.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,170.53 / $1,170.53 / $1,242.20
| Professional | | $1,170.53 | $1,170.53 | $1,242.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $826.56 / $978.28 / $4,496.89
| Professional | | $826.56 | $978.28 | $4,496.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $1,280.50 / $2,003.00
| Professional | | $10.00 | $1,280.50 | $2,003.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $830.51 / $1,123.99 / $1,757.73
| Professional | | $830.51 | $1,123.99 | $1,757.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.23 / $756.23 / $884.73
| Facility | | $756.23 | $756.23 | $884.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $720.63 / $771.35 / $884.73
| Professional | | $720.63 | $771.35 | $884.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $3,742.00
| Facility | | $435.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $789.78 / $1,031.70 / $1,791.27
| Professional | | $789.78 | $1,031.70 | $1,791.27 |