- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.04 / $2,747.00 / $8,017.00
| Facility | | $540.04 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.29 / $468.05 / $623.28
| Professional | | $330.29 | $468.05 | $623.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.38 / $514.07 / $842.67
| Professional | | $495.38 | $514.07 | $842.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.85 / $497.42 / $827.65
| Professional | | $344.85 | $497.42 | $827.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.73 / $768.51 / $793.17
| Professional | | $597.73 | $768.51 | $793.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,980.98 / $6,980.98 / $6,980.98
| Facility | | $6,980.98 | $6,980.98 | $6,980.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,077.00 / $8,017.00
| Facility | | $832.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.66 / $528.65 / $1,877.51
| Professional | | $355.66 | $528.65 | $1,877.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.10 / $537.10 / $569.00
| Professional | | $537.10 | $537.10 | $569.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.57 / $606.57 / $606.57
| Facility | | $606.57 | $606.57 | $606.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.64 / $510.51 / $827.66
| Professional | | $355.64 | $510.51 | $827.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.10 / $431.99 / $492.06
| Facility | | $350.10 | $431.99 | $492.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.10 / $460.39 / $527.66
| Professional | | $350.10 | $460.39 | $527.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $2,391.00 / $6,000.00
| Facility | | $637.00 | $2,391.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.02 / $566.16 / $921.94
| Professional | | $435.02 | $566.16 | $921.94 |