- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.56 / $465.07 / $612.41
| Professional | | $418.56 | $465.07 | $612.41 |
- 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
- $343.10 / $552.67 / $803.32
| Professional | | $343.10 | $552.67 | $803.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.46 / $525.51 / $828.25
| Professional | | $375.46 | $525.51 | $828.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $594.30 / $594.30 / $626.82
| Professional | | $594.30 | $594.30 | $626.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,032.12 / $4,032.12 / $4,032.12
| Facility | | $4,032.12 | $4,032.12 | $4,032.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.49 / $422.49 / $422.49
| Professional | | $422.49 | $422.49 | $422.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.20 / $486.16 / $2,350.66
| Professional | | $411.20 | $486.16 | $2,350.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $661.00 / $970.70
| Professional | | $3.00 | $661.00 | $970.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.30 / $539.62 / $828.25
| Professional | | $385.30 | $539.62 | $828.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.26 / $379.78 / $424.35
| Facility | | $352.26 | $379.78 | $424.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.26 / $379.78 / $424.35
| Professional | | $352.26 | $379.78 | $424.35 |
- 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
- $390.81 / $506.50 / $836.51
| Professional | | $390.81 | $506.50 | $836.51 |