- 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
- $355.09 / $403.51 / $541.52
| Professional | | $355.09 | $403.51 | $541.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.33 / $451.76 / $451.76
| Professional | | $435.33 | $451.76 | $451.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.30 / $549.90 / $886.50
| Professional | | $416.30 | $549.90 | $886.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.82 / $688.29 / $688.29
| Professional | | $517.82 | $688.29 | $688.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.82 / $463.04 / $2,252.16
| Professional | | $370.82 | $463.04 | $2,252.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $491.60 / $1,123.20
| Professional | | $6.00 | $491.60 | $1,123.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.31 / $555.96 / $941.82
| Professional | | $418.31 | $555.96 | $941.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.98 / $430.98 / $471.82
| Facility | | $430.98 | $430.98 | $471.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.96 / $432.92 / $471.82
| Professional | | $417.96 | $432.92 | $471.82 |
- 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
- $369.32 / $533.35 / $912.80
| Professional | | $369.32 | $533.35 | $912.80 |