- 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
- $591.17 / $679.16 / $1,095.20
| Professional | | $591.17 | $679.16 | $1,095.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $713.14 / $740.05 / $1,203.68
| Professional | | $713.14 | $740.05 | $1,203.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.77 / $910.08 / $1,443.61
| Professional | | $672.77 | $910.08 | $1,443.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $843.73 / $1,121.58 / $1,121.58
| Professional | | $843.73 | $1,121.58 | $1,121.58 |
- 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
- $622.14 / $770.06 / $2,172.41
| Professional | | $622.14 | $770.06 | $2,172.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $562.50 / $1,815.30
| Professional | | $6.00 | $562.50 | $1,815.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.31 / $921.60 / $1,510.97
| Professional | | $680.31 | $921.60 | $1,510.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.15 / $704.77 / $704.77
| Facility | | $641.15 | $704.77 | $704.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $641.15 / $704.77 / $741.09
| Professional | | $641.15 | $704.77 | $741.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.79 / $902.81 / $1,432.77
| Professional | | $665.79 | $902.81 | $1,432.77 |