- 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
- $597.66 / $669.76 / $909.43
| Professional | | $597.66 | $669.76 | $909.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.04 / $1,018.28 / $1,355.17
| Professional | | $644.04 | $1,018.28 | $1,355.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.76 / $948.93 / $1,472.33
| Professional | | $708.76 | $948.93 | $1,472.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $861.15 / $1,144.77 / $1,144.77
| Professional | | $861.15 | $1,144.77 | $1,144.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,342.48 / $1,342.48 / $1,342.48
| Facility | | $1,342.48 | $1,342.48 | $1,342.48 |
- 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
- $634.19 / $761.30 / $2,660.00
| Professional | | $634.19 | $761.30 | $2,660.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $915.90 / $1,842.80
| Professional | | $6.00 | $915.90 | $1,842.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $714.16 / $951.89 / $1,701.43
| Professional | | $714.16 | $951.89 | $1,701.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.40 / $720.40 / $830.25
| Facility | | $720.40 | $720.40 | $830.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $695.60 / $726.84 / $830.25
| Professional | | $695.60 | $726.84 | $830.25 |
- 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
- $692.16 / $927.07 / $1,504.43
| Professional | | $692.16 | $927.07 | $1,504.43 |