- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $5,079.00 / $9,534.00
| Facility | | $882.00 | $5,079.00 | $9,534.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $692.76 / $780.90 / $3,000.88
| Professional | | $692.76 | $780.90 | $3,000.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,850.00 / $16,455.00 / $36,032.05
| Facility | | $8,850.00 | $16,455.00 | $36,032.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $666.66 / $1,061.08 / $1,608.20
| Professional | | $666.66 | $1,061.08 | $1,608.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.81 / $977.31 / $1,597.70
| Professional | | $728.81 | $977.31 | $1,597.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $879.62 / $1,163.80 / $1,167.25
| Professional | | $879.62 | $1,163.80 | $1,167.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,680.90 / $18,718.25 / $33,682.06
| Facility | | $10,680.90 | $18,718.25 | $33,682.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.00 / $5,403.00 / $9,830.00
| Facility | | $1,298.00 | $5,403.00 | $9,830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $692.76 / $853.61 / $3,039.00
| Professional | | $692.76 | $853.61 | $3,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $888.10 / $1,874.00
| Professional | | $6.00 | $888.10 | $1,874.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $748.65 / $984.98 / $1,622.19
| Professional | | $748.65 | $984.98 | $1,622.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.13 / $734.13 / $827.94
| Facility | | $734.13 | $734.13 | $827.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $711.72 / $737.88 / $827.94
| Professional | | $711.72 | $737.88 | $827.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $711.32 / $946.21 / $1,547.40
| Professional | | $711.32 | $946.21 | $1,547.40 |