- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.17 / $643.51 / $1,082.75
| Professional | | $583.17 | $643.51 | $1,082.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $679.60 / $705.24 / $705.24
| Professional | | $679.60 | $705.24 | $705.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.03 / $781.03 / $781.03
| Facility | | $781.03 | $781.03 | $781.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.44 / $812.44 / $1,359.14
| Professional | | $568.44 | $812.44 | $1,359.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $811.88 / $1,128.64 / $1,402.33
| Professional | | $811.88 | $1,128.64 | $1,402.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,077.00 / $8,017.00
| Facility | | $934.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $599.98 / $766.27 / $3,447.26
| Professional | | $599.98 | $766.27 | $3,447.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $671.20 / $671.20 / $1,379.70
| Professional | | $671.20 | $671.20 | $1,379.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.03 / $781.03 / $781.03
| Facility | | $781.03 | $781.03 | $781.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.54 / $833.47 / $1,369.05
| Professional | | $582.54 | $833.47 | $1,369.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.29 / $676.29 / $780.97
| Facility | | $676.29 | $676.29 | $780.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $647.37 / $687.68 / $780.97
| Professional | | $647.37 | $687.68 | $780.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.04 / $839.07 / $1,267.76
| Professional | | $633.04 | $839.07 | $1,267.76 |