- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $862.00 / $3,839.00 / $8,247.00
| Facility | | $862.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.79 / $862.00 / $1,075.35
| Professional | | $741.79 | $862.00 | $1,075.35 |
- 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
- $899.59 / $933.54 / $933.54
| Professional | | $899.59 | $933.54 | $933.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $883.22 / $1,145.70 / $1,829.02
| Professional | | $883.22 | $1,145.70 | $1,829.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,100.11 / $1,479.91 / $1,479.91
| Professional | | $1,100.11 | $1,479.91 | $1,479.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,774.88 / $10,774.88 / $10,774.88
| Facility | | $10,774.88 | $10,774.88 | $10,774.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.79 / $929.47 / $2,560.14
| Professional | | $741.79 | $929.47 | $2,560.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,005.50 / $2,259.00
| Professional | | $6.00 | $1,005.50 | $2,259.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $883.22 / $1,150.11 / $1,912.17
| Professional | | $883.22 | $1,150.11 | $1,912.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.95 / $885.60 / $885.60
| Facility | | $830.95 | $885.60 | $885.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $830.95 / $885.60 / $935.04
| Professional | | $830.95 | $885.60 | $935.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $822.18 / $1,102.48 / $1,756.69
| Professional | | $822.18 | $1,102.48 | $1,756.69 |