- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $4,304.00 / $8,404.00
| Facility | | $882.00 | $4,304.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.14 / $582.53 / $763.72
| Professional | | $537.14 | $582.53 | $763.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $596.65 / $619.16 / $619.16
| Professional | | $596.65 | $619.16 | $619.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.14 / $751.40 / $1,271.79
| Professional | | $538.14 | $751.40 | $1,271.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.05 / $937.93 / $940.77
| Professional | | $707.05 | $937.93 | $940.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,966.94 / $4,340.75 / $12,323.67
| Facility | | $2,966.94 | $4,340.75 | $12,323.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,404.00
| Facility | | $1,013.00 | $4,761.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.14 / $596.16 / $3,086.90
| Professional | | $537.14 | $596.16 | $3,086.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $713.80 / $1,522.10
| Professional | | $6.00 | $713.80 | $1,522.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $577.71 / $762.97 / $1,271.79
| Professional | | $577.71 | $762.97 | $1,271.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.83 / $586.08 / $586.08
| Facility | | $559.83 | $586.08 | $586.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.83 / $586.08 / $619.35
| Professional | | $559.83 | $586.08 | $619.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.87 / $728.83 / $1,167.22
| Professional | | $556.87 | $728.83 | $1,167.22 |