- 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
- $483.47 / $566.11 / $709.18
| Professional | | $483.47 | $566.11 | $709.18 |
- 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
- $560.49 / $581.64 / $581.64
| Professional | | $560.49 | $581.64 | $581.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.05 / $722.02 / $1,127.16
| Professional | | $541.05 | $722.02 | $1,127.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $655.49 / $867.44 / $872.87
| Professional | | $655.49 | $867.44 | $872.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,576.04 / $3,576.04 / $32,920.22
| Facility | | $3,576.04 | $3,576.04 | $32,920.22 |
- 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
- $494.71 / $598.82 / $1,675.08
| Professional | | $494.71 | $598.82 | $1,675.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $700.00 / $1,395.90
| Professional | | $3.00 | $700.00 | $1,395.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $542.63 / $731.24 / $1,140.82
| Professional | | $542.63 | $731.24 | $1,140.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.42 / $543.42 / $618.10
| Facility | | $543.42 | $543.42 | $618.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.78 / $545.22 / $618.10
| Professional | | $527.78 | $545.22 | $618.10 |
- 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
- $521.53 / $685.21 / $1,178.05
| Professional | | $521.53 | $685.21 | $1,178.05 |