- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,623.00 / $7,799.00
| Facility | | $768.00 | $3,623.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.22 / $825.48 / $1,139.03
| Professional | | $336.22 | $825.48 | $1,139.03 |
- 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
- $679.97 / $1,069.93 / $1,565.39
| Professional | | $679.97 | $1,069.93 | $1,565.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.59 / $733.47 / $1,556.31
| Professional | | $355.59 | $733.47 | $1,556.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,255.54 / $1,255.54 / $1,270.74
| Professional | | $1,255.54 | $1,255.54 | $1,270.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.17 / $363.17 / $363.17
| Professional | | $363.17 | $363.17 | $363.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.52 / $842.66 / $1,723.43
| Professional | | $338.52 | $842.66 | $1,723.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.33 / $806.43 / $1,620.46
| Professional | | $314.33 | $806.43 | $1,620.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.58 / $763.60 / $1,502.16
| Professional | | $374.58 | $763.60 | $1,502.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.32 / $687.10 / $2,108.41
| Facility | | $325.32 | $687.10 | $2,108.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.32 / $687.10 / $859.05
| Professional | | $325.32 | $687.10 | $859.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.00 / $3,475.00 / $6,000.00
| Facility | | $1,440.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $855.26 / $1,120.40 / $1,718.11
| Professional | | $855.26 | $1,120.40 | $1,718.11 |