- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.58 / $485.50 / $616.21
| Professional | | $430.58 | $485.50 | $616.21 |
- 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
- $487.83 / $506.24 / $506.24
| Professional | | $487.83 | $506.24 | $506.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.52 / $628.69 / $985.80
| Professional | | $470.52 | $628.69 | $985.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.62 / $755.19 / $759.58
| Professional | | $570.62 | $755.19 | $759.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.58 / $520.23 / $2,562.41
| Professional | | $430.58 | $520.23 | $2,562.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $623.79 / $1,214.50
| Professional | | $3.00 | $623.79 | $1,214.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.65 / $635.91 / $996.31
| Professional | | $472.65 | $635.91 | $996.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.19 / $472.19 / $519.08
| Facility | | $472.19 | $472.19 | $519.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.58 / $473.75 / $519.08
| Professional | | $458.58 | $473.75 | $519.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.21 / $597.63 / $973.32
| Professional | | $476.21 | $597.63 | $973.32 |