- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $4,761.00 / $8,451.00
| Facility | | $921.00 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.95 / $506.34 / $680.23
| Professional | | $444.95 | $506.34 | $680.23 |
- 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
- $548.83 / $569.54 / $569.54
| Professional | | $548.83 | $569.54 | $569.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.67 / $705.63 / $1,116.33
| Professional | | $523.67 | $705.63 | $1,116.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $651.65 / $866.29 / $866.29
| Professional | | $651.65 | $866.29 | $866.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,342.00 / $9,617.00
| Facility | | $1,054.00 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.24 / $606.70 / $2,843.00
| Professional | | $463.24 | $606.70 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $682.30 / $1,405.70
| Professional | | $7.00 | $682.30 | $1,405.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.80 / $705.63 / $1,282.48
| Professional | | $529.80 | $705.63 | $1,282.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.96 / $540.96 / $559.53
| Facility | | $540.96 | $540.96 | $559.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.23 / $543.79 / $570.36
| Professional | | $525.23 | $543.79 | $570.36 |
- 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
- $496.06 / $675.33 / $1,087.84
| Professional | | $496.06 | $675.33 | $1,087.84 |