- 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
- $689.92 / $789.42 / $999.87
| Professional | | $689.92 | $789.42 | $999.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $694.79 / $1,105.89 / $1,484.92
| Professional | | $694.79 | $1,105.89 | $1,484.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $759.77 / $1,016.95 / $1,596.06
| Professional | | $759.77 | $1,016.95 | $1,596.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $918.07 / $1,214.78 / $1,219.33
| Professional | | $918.07 | $1,214.78 | $1,219.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $700.00 / $845.40 / $3,494.00
| Professional | | $700.00 | $845.40 | $3,494.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $984.20 / $1,957.50
| Professional | | $3.00 | $984.20 | $1,957.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $780.25 / $1,026.83 / $1,649.41
| Professional | | $780.25 | $1,026.83 | $1,649.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.12 / $765.12 / $867.02
| Facility | | $765.12 | $765.12 | $867.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $742.14 / $768.65 / $867.02
| Professional | | $742.14 | $768.65 | $867.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $764.66 / $968.65 / $1,584.56
| Professional | | $764.66 | $968.65 | $1,584.56 |