- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $823.52 / $925.91 / $1,195.50
| Professional | | $823.52 | $925.91 | $1,195.50 |
- 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
- $941.32 / $976.84 / $976.84
| Professional | | $941.32 | $976.84 | $976.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $908.32 / $1,217.66 / $1,918.61
| Professional | | $908.32 | $1,217.66 | $1,918.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,095.83 / $1,449.81 / $1,454.80
| Professional | | $1,095.83 | $1,449.81 | $1,454.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $0.50 / $37,447.19
| Facility | | $0.50 | $0.50 | $37,447.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $4,070.00 / $8,017.00
| Facility | | $954.00 | $4,070.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $823.52 / $1,015.74 / $3,494.00
| Professional | | $823.52 | $1,015.74 | $3,494.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,248.30 / $2,334.80
| Professional | | $3.00 | $1,248.30 | $2,334.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $932.44 / $1,227.58 / $2,038.17
| Professional | | $932.44 | $1,227.58 | $2,038.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.48 / $914.48 / $1,058.16
| Facility | | $914.48 | $914.48 | $1,058.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $886.70 / $919.02 / $1,058.16
| Professional | | $886.70 | $919.02 | $1,058.16 |
- 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
- $935.29 / $1,204.16 / $1,926.40
| Professional | | $935.29 | $1,204.16 | $1,926.40 |