- 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
- $698.54 / $808.01 / $1,014.49
| Professional | | $698.54 | $808.01 | $1,014.49 |
- 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
- $799.11 / $829.27 / $829.27
| Professional | | $799.11 | $829.27 | $829.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $770.88 / $1,031.95 / $1,623.89
| Professional | | $770.88 | $1,031.95 | $1,623.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.33 / $1,230.81 / $1,235.35
| Professional | | $930.33 | $1,230.81 | $1,235.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,085.06 / $14,085.06 / $14,085.06
| Facility | | $14,085.06 | $14,085.06 | $14,085.06 |
- 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
- $700.00 / $857.95 / $2,843.00
| Professional | | $700.00 | $857.95 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,082.09 / $1,980.70
| Professional | | $3.00 | $1,082.09 | $1,980.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $781.10 / $1,041.83 / $1,685.41
| Professional | | $781.10 | $1,041.83 | $1,685.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.07 / $776.07 / $976.74
| Facility | | $776.07 | $776.07 | $976.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $752.53 / $779.88 / $976.74
| Professional | | $752.53 | $779.88 | $976.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.48 / $1,052.18 / $1,664.75
| Professional | | $794.48 | $1,052.18 | $1,664.75 |