- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $522.83 / $591.76 / $755.66
| Professional | | $522.83 | $591.76 | $755.66 |
- 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
- $597.82 / $620.38 / $620.38
| Professional | | $597.82 | $620.38 | $620.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.84 / $769.96 / $1,177.01
| Professional | | $566.84 | $769.96 | $1,177.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $699.62 / $925.95 / $931.57
| Professional | | $699.62 | $925.95 | $931.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $545.11 / $639.02 / $2,843.00
| Professional | | $545.11 | $639.02 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $720.40 / $1,489.30
| Professional | | $3.00 | $720.40 | $1,489.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.38 / $778.98 / $1,203.56
| Professional | | $576.38 | $778.98 | $1,203.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.12 / $579.12 / $585.87
| Facility | | $579.12 | $579.12 | $585.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.50 / $580.97 / $607.91
| Professional | | $562.50 | $580.97 | $607.91 |
- 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
- $512.90 / $729.20 / $1,173.68
| Professional | | $512.90 | $729.20 | $1,173.68 |