- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.54 / $734.79 / $1,417.25
| Professional | | $627.54 | $734.79 | $1,417.25 |
- 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
- $716.75 / $743.80 / $743.80
| Professional | | $716.75 | $743.80 | $743.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.49 / $924.62 / $1,450.34
| Professional | | $672.49 | $924.62 | $1,450.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $835.99 / $1,106.15 / $1,111.18
| Professional | | $835.99 | $1,106.15 | $1,111.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,443.40 / $8,443.40 / $8,443.40
| Facility | | $8,443.40 | $8,443.40 | $8,443.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $656.04 / $803.41 / $2,843.00
| Professional | | $656.04 | $803.41 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $968.50 / $1,782.30
| Professional | | $3.00 | $968.50 | $1,782.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.53 / $934.61 / $1,541.80
| Professional | | $691.53 | $934.61 | $1,541.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.28 / $696.28 / $800.73
| Facility | | $696.28 | $696.28 | $800.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.53 / $699.31 / $800.73
| Professional | | $675.53 | $699.31 | $800.73 |
- 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
- $695.23 / $876.52 / $1,450.11
| Professional | | $695.23 | $876.52 | $1,450.11 |