- 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
- $422.31 / $470.44 / $809.52
| Professional | | $422.31 | $470.44 | $809.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.05 / $539.67 / $922.05
| Professional | | $520.05 | $539.67 | $922.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.57 / $592.57 / $592.57
| Facility | | $592.57 | $592.57 | $592.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.19 / $572.44 / $964.21
| Professional | | $391.19 | $572.44 | $964.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $628.27 / $875.42 / $1,085.19
| Professional | | $628.27 | $875.42 | $1,085.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,077.00 / $8,017.00
| Facility | | $954.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.01 / $565.48 / $2,565.30
| Professional | | $432.01 | $565.48 | $2,565.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.10 / $423.10 / $1,053.59
| Professional | | $423.10 | $423.10 | $1,053.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.57 / $592.57 / $592.57
| Facility | | $592.57 | $592.57 | $592.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.07 / $585.11 / $964.21
| Professional | | $420.07 | $585.11 | $964.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.26 / $503.44 / $503.44
| Facility | | $417.26 | $503.44 | $503.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.26 / $503.44 / $539.16
| Professional | | $417.26 | $503.44 | $539.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $2,391.00 / $3,905.54
| Facility | | $912.00 | $2,391.00 | $3,905.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.47 / $601.91 / $942.44
| Professional | | $427.47 | $601.91 | $942.44 |