- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,838.00 / $8,104.00
| Facility | | $768.00 | $3,838.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.59 / $553.87 / $971.04
| Professional | | $496.59 | $553.87 | $971.04 |
- 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
- $608.42 / $631.39 / $631.39
| Professional | | $608.42 | $631.39 | $631.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.12 / $746.19 / $1,169.89
| Professional | | $537.12 | $746.19 | $1,169.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $726.63 / $966.34 / $966.34
| Professional | | $726.63 | $966.34 | $966.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,357.35 / $6,357.35 / $6,715.99
| Facility | | $6,357.35 | $6,357.35 | $6,715.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.86 / $606.50 / $1,692.36
| Professional | | $518.86 | $606.50 | $1,692.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $647.29 / $1,583.00
| Professional | | $5.00 | $647.29 | $1,583.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $569.60 / $752.08 / $1,246.86
| Professional | | $569.60 | $752.08 | $1,246.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.85 / $599.85 / $607.11
| Facility | | $599.85 | $599.85 | $607.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.35 / $601.89 / $635.04
| Professional | | $582.35 | $601.89 | $635.04 |
- 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
- $527.78 / $717.10 / $1,179.83
| Professional | | $527.78 | $717.10 | $1,179.83 |