- 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
- $590.14 / $688.93 / $1,069.33
| Professional | | $590.14 | $688.93 | $1,069.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.34 / $706.01 / $1,091.07
| Professional | | $680.34 | $706.01 | $1,091.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.06 / $774.06 / $774.06
| Facility | | $774.06 | $774.06 | $774.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $656.18 / $866.47 / $1,372.37
| Professional | | $656.18 | $866.47 | $1,372.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.71 / $1,081.58 / $1,372.67
| Professional | | $794.71 | $1,081.58 | $1,372.67 |
- 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
- $596.02 / $847.36 / $2,843.00
| Professional | | $596.02 | $847.36 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $908.10 / $908.10 / $1,371.40
| Professional | | $908.10 | $908.10 | $1,371.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.06 / $774.06 / $774.06
| Facility | | $774.06 | $774.06 | $774.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $656.18 / $877.38 / $1,401.13
| Professional | | $656.18 | $877.38 | $1,401.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.09 / $667.09 / $693.39
| Facility | | $667.09 | $667.09 | $693.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $641.77 / $675.39 / $700.37
| Professional | | $641.77 | $675.39 | $700.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $654.75 / $884.79 / $1,354.85
| Professional | | $654.75 | $884.79 | $1,354.85 |