- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $872.00 / $3,213.00 / $11,453.00
| Facility | | $872.00 | $3,213.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $917.38 / $1,020.52 / $1,426.89
| Professional | | $917.38 | $1,020.52 | $1,426.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,999.43 / $3,414.76 / $11,269.44
| Facility | | $1,999.43 | $3,414.76 | $11,269.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $913.43 / $957.06 / $1,272.89
| Professional | | $913.43 | $957.06 | $1,272.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $877.70 / $877.70 / $892.29
| Facility | | $877.70 | $877.70 | $892.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $934.13 / $1,216.91 / $1,698.69
| Professional | | $934.13 | $1,216.91 | $1,698.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $16,547.20
| Facility | | $55.00 | $55.00 | $16,547.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,507.56 / $7,507.56 / $8,538.45
| Professional | | $7,507.56 | $7,507.56 | $8,538.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.94 / $1,089.18 / $1,483.60
| Facility | | $933.94 | $1,089.18 | $1,483.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $980.75 / $1,569.20 / $1,961.50
| Professional | | $980.75 | $1,569.20 | $1,961.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $938.42 / $1,093.95 / $1,524.79
| Facility | | $938.42 | $1,093.95 | $1,524.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $937.72 / $1,260.33 / $1,902.52
| Professional | | $937.72 | $1,260.33 | $1,902.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,237.00
| Facility | | $2,093.00 | $6,000.00 | $13,237.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $742.56 / $1,031.33 / $1,485.13
| Professional | | $742.56 | $1,031.33 | $1,485.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $837.04 / $951.26 / $1,320.89
| Professional | | $837.04 | $951.26 | $1,320.89 |