- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.91 / $3,596.00 / $12,012.51
| Facility | | $765.91 | $3,596.00 | $12,012.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.03 / $651.39 / $956.02
| Professional | | $583.03 | $651.39 | $956.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.33 / $701.61 / $968.10
| Professional | | $575.33 | $701.61 | $968.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.79 / $539.79 / $546.45
| Facility | | $539.79 | $539.79 | $546.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.65 / $2,024.00 / $4,619.00
| Facility | | $711.65 | $2,024.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $612.73 / $824.70 / $1,309.90
| Professional | | $612.73 | $824.70 | $1,309.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $5,046.30
| Facility | | $55.00 | $55.00 | $5,046.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,421.14 / $6,421.14 / $6,421.14
| Professional | | $6,421.14 | $6,421.14 | $6,421.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.13 / $776.76 / $1,443.22
| Facility | | $609.13 | $776.76 | $1,443.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.51 / $941.30 / $1,107.41
| Professional | | $707.51 | $941.30 | $1,107.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,099.30 / $1,595.20
| Professional | | $6.00 | $1,099.30 | $1,595.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.52 / $785.22 / $1,620.92
| Facility | | $609.52 | $785.22 | $1,620.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.88 / $879.68 / $1,572.85
| Professional | | $633.88 | $879.68 | $1,572.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,970.00 / $8,583.00
| Facility | | $385.00 | $1,970.00 | $8,583.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.74 / $675.02 / $1,072.28
| Professional | | $510.74 | $675.02 | $1,072.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.08 / $613.70 / $830.29
| Professional | | $525.08 | $613.70 | $830.29 |