- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,422.00 / $7,799.00
| Facility | | $594.00 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.38 / $503.67 / $634.33
| Professional | | $438.38 | $503.67 | $634.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,928.32 / $5,951.00 / $8,887.00
| Facility | | $3,928.32 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.01 / $702.32 / $955.04
| Professional | | $442.01 | $702.32 | $955.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.02 / $646.62 / $1,045.89
| Professional | | $484.02 | $646.62 | $1,045.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $585.36 / $774.56 / $779.06
| Professional | | $585.36 | $774.56 | $779.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,125.73 / $11,658.20 / $19,911.09
| Facility | | $8,125.73 | $11,658.20 | $19,911.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,371.00 / $8,017.00
| Facility | | $641.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.66 / $558.19 / $1,544.00
| Professional | | $457.66 | $558.19 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $770.40 / $1,247.20
| Professional | | $3.00 | $770.40 | $1,247.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.98 / $654.16 / $1,092.11
| Professional | | $493.98 | $654.16 | $1,092.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.91 / $485.91 / $2,519.35
| Facility | | $485.91 | $485.91 | $2,519.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.76 / $487.67 / $2,519.35
| Professional | | $471.76 | $487.67 | $2,519.35 |
- 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
- $484.47 / $622.45 / $1,010.67
| Professional | | $484.47 | $622.45 | $1,010.67 |