- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.55 / $476.05 / $661.66
| Professional | | $409.55 | $476.05 | $661.66 |
- 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
- $498.33 / $517.13 / $517.13
| Professional | | $498.33 | $517.13 | $517.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.20 / $650.63 / $1,010.11
| Professional | | $488.20 | $650.63 | $1,010.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.36 / $819.45 / $819.45
| Professional | | $609.36 | $819.45 | $819.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.09 / $513.17 / $2,525.86
| Professional | | $419.09 | $513.17 | $2,525.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $589.50 / $1,249.09
| Professional | | $4.00 | $589.50 | $1,249.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.33 / $655.10 / $1,083.68
| Professional | | $488.33 | $655.10 | $1,083.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.12 / $490.12 / $540.94
| Facility | | $490.12 | $490.12 | $540.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.61 / $499.04 / $540.94
| Professional | | $468.61 | $499.04 | $540.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $2,391.00 / $4,789.00
| Facility | | $912.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.94 / $627.84 / $997.25
| Professional | | $454.94 | $627.84 | $997.25 |