- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.11 / $657.36 / $887.36
| Professional | | $579.11 | $657.36 | $887.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.29 / $967.55 / $1,395.94
| Professional | | $629.29 | $967.55 | $1,395.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.04 / $912.77 / $1,444.77
| Professional | | $673.04 | $912.77 | $1,444.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $844.67 / $1,122.84 / $1,122.84
| Professional | | $844.67 | $1,122.84 | $1,122.84 |
- 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
- $600.03 / $720.46 / $3,494.00
| Professional | | $600.03 | $720.46 | $3,494.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $724.90 / $1,818.10
| Professional | | $6.00 | $724.90 | $1,818.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.58 / $924.57 / $1,563.33
| Professional | | $680.58 | $924.57 | $1,563.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.48 / $704.48 / $735.19
| Facility | | $704.48 | $704.48 | $735.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $681.64 / $709.30 / $741.17
| Professional | | $681.64 | $709.30 | $741.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.00 / $3,475.00 / $6,000.00
| Facility | | $2,222.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $650.91 / $881.64 / $1,542.84
| Professional | | $650.91 | $881.64 | $1,542.84 |