- 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
- $606.57 / $782.38 / $1,057.20
| Professional | | $606.57 | $782.38 | $1,057.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $857.14 / $889.48 / $1,450.72
| Professional | | $857.14 | $889.48 | $1,450.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.11 / $973.11 / $973.11
| Facility | | $973.11 | $973.11 | $973.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.22 / $917.96 / $1,614.12
| Professional | | $583.22 | $917.96 | $1,614.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,032.09 / $1,446.53 / $1,782.71
| Professional | | $1,032.09 | $1,446.53 | $1,782.71 |
- 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
- $694.86 / $897.12 / $4,231.85
| Professional | | $694.86 | $897.12 | $4,231.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $693.20 / $693.20 / $1,726.30
| Professional | | $693.20 | $693.20 | $1,726.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.11 / $973.11 / $973.11
| Facility | | $973.11 | $973.11 | $973.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.71 / $934.08 / $1,614.12
| Professional | | $645.71 | $934.08 | $1,614.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $619.79 / $831.30 / $831.30
| Facility | | $619.79 | $831.30 | $831.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.79 / $831.30 / $887.04
| Professional | | $619.79 | $831.30 | $887.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $678.63 / $1,002.69 / $1,663.83
| Professional | | $678.63 | $1,002.69 | $1,663.83 |