- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.03 / $3,839.00 / $8,247.00
| Facility | | $680.03 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.80 / $652.91 / $841.33
| Professional | | $603.80 | $652.91 | $841.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.70 / $704.31 / $704.31
| Professional | | $678.70 | $704.31 | $704.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.95 / $871.33 / $1,440.16
| Professional | | $630.95 | $871.33 | $1,440.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $819.54 / $1,096.77 / $1,096.77
| Professional | | $819.54 | $1,096.77 | $1,096.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.03 / $4,761.00 / $8,247.00
| Facility | | $680.03 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.80 / $683.73 / $2,843.00
| Professional | | $603.80 | $683.73 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $964.50 / $1,721.10
| Professional | | $6.00 | $964.50 | $1,721.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $656.43 / $879.54 / $1,440.16
| Professional | | $656.43 | $879.54 | $1,440.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $663.67 / $663.67 / $708.03
| Facility | | $663.67 | $663.67 | $708.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $638.11 / $672.18 / $708.03
| Professional | | $638.11 | $672.18 | $708.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $658.98 / $854.52 / $1,381.12
| Professional | | $658.98 | $854.52 | $1,381.12 |