- 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
- $595.35 / $692.58 / $1,102.13
| Professional | | $595.35 | $692.58 | $1,102.13 |
- 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
- $708.26 / $734.99 / $734.99
| Professional | | $708.26 | $734.99 | $734.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $668.17 / $903.85 / $1,434.51
| Professional | | $668.17 | $903.85 | $1,434.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $838.44 / $1,114.60 / $1,114.60
| Professional | | $838.44 | $1,114.60 | $1,114.60 |
- 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
- $631.91 / $773.80 / $2,644.00
| Professional | | $631.91 | $773.80 | $2,644.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $494.90 / $1,804.40
| Professional | | $6.00 | $494.90 | $1,804.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.67 / $914.57 / $1,489.40
| Professional | | $675.67 | $914.57 | $1,489.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.36 / $699.36 / $702.11
| Facility | | $699.36 | $699.36 | $702.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.56 / $702.11 / $735.61
| Professional | | $676.56 | $702.11 | $735.61 |
- 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
- $646.49 / $895.88 / $1,420.61
| Professional | | $646.49 | $895.88 | $1,420.61 |