- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.42 / $2,747.00 / $8,113.00
| Facility | | $315.42 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.52 / $425.40 / $600.85
| Professional | | $279.52 | $425.40 | $600.85 |
- 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
- $434.08 / $450.46 / $811.35
| Professional | | $434.08 | $450.46 | $811.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.58 / $389.59 / $613.71
| Professional | | $249.58 | $389.59 | $613.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.17 / $537.17 / $692.71
| Professional | | $537.17 | $537.17 | $692.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.52 / $440.70 / $1,551.52
| Professional | | $279.52 | $440.70 | $1,551.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.40 / $342.40 / $342.40
| Professional | | $342.40 | $342.40 | $342.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.04 / $391.53 / $613.71
| Professional | | $256.04 | $391.53 | $613.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.02 / $281.00 / $436.55
| Facility | | $213.02 | $281.00 | $436.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.02 / $335.57 / $470.80
| Professional | | $276.02 | $335.57 | $470.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.62 / $512.79 / $868.12
| Professional | | $364.62 | $512.79 | $868.12 |