- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.39 / $2,747.00 / $8,247.00
| Facility | | $536.39 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.28 / $499.07 / $815.03
| Professional | | $452.28 | $499.07 | $815.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $25,716.00 / $39,341.64
| Facility | | $8,639.91 | $25,716.00 | $39,341.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.60 / $543.36 / $543.36
| Professional | | $523.60 | $543.36 | $543.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.54 / $592.54 / $592.54
| Facility | | $592.54 | $592.54 | $592.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.79 / $627.33 / $1,030.07
| Professional | | $431.79 | $627.33 | $1,030.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.91 / $849.82 / $1,070.76
| Professional | | $619.91 | $849.82 | $1,070.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,427.00
| Facility | | $832.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.28 / $541.22 / $2,683.07
| Professional | | $452.28 | $541.22 | $2,683.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.29 / $543.29 / $1,067.30
| Professional | | $543.29 | $543.29 | $1,067.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.54 / $592.54 / $592.54
| Facility | | $592.54 | $592.54 | $592.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.99 / $645.57 / $1,046.72
| Professional | | $448.99 | $645.57 | $1,046.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.59 / $510.59 / $646.65
| Facility | | $510.59 | $510.59 | $646.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.59 / $516.42 / $646.65
| Professional | | $491.59 | $516.42 | $646.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.00 / $2,391.00 / $6,322.00
| Facility | | $448.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.86 / $641.75 / $986.36
| Professional | | $487.86 | $641.75 | $986.36 |