- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.39 / $2,483.00 / $7,629.00
| Facility | | $665.39 | $2,483.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.32 / $665.39 / $969.32
| Professional | | $576.32 | $665.39 | $969.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,850.00 / $16,455.00 / $36,032.05
| Facility | | $8,850.00 | $16,455.00 | $36,032.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $642.63 / $756.03 / $1,170.04
| Professional | | $642.63 | $756.03 | $1,170.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.02 / $947.90 / $1,535.77
| Professional | | $709.02 | $947.90 | $1,535.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $858.07 / $1,138.11 / $1,138.11
| Professional | | $858.07 | $1,138.11 | $1,138.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.66 / $17,392.59 / $38,431.82
| Facility | | $9,930.66 | $17,392.59 | $38,431.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,422.00 / $8,017.00
| Facility | | $657.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $608.55 / $746.26 / $1,978.00
| Professional | | $608.55 | $746.26 | $1,978.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $1,676.80
| Professional | | $5.00 | $5.00 | $1,676.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $713.03 / $930.48 / $1,625.21
| Professional | | $713.03 | $930.48 | $1,625.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.31 / $714.31 / $728.68
| Facility | | $714.31 | $714.31 | $728.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $692.81 / $717.55 / $751.20
| Professional | | $692.81 | $717.55 | $751.20 |
- 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
- $692.93 / $952.21 / $1,433.91
| Professional | | $692.93 | $952.21 | $1,433.91 |