- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.57 / $2,747.00 / $8,017.00
| Facility | | $489.57 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.15 / $438.43 / $585.76
| Professional | | $371.15 | $438.43 | $585.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.33 / $456.95 / $808.37
| Professional | | $440.33 | $456.95 | $808.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.39 / $434.65 / $708.59
| Professional | | $323.39 | $434.65 | $708.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.27 / $534.27 / $688.96
| Professional | | $534.27 | $534.27 | $688.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.32 / $466.96 / $2,405.39
| Professional | | $378.32 | $466.96 | $2,405.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.40 / $546.40 / $546.40
| Professional | | $546.40 | $546.40 | $546.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.32 / $445.55 / $708.59
| Professional | | $332.32 | $445.55 | $708.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.92 / $431.84 / $450.76
| Facility | | $374.92 | $431.84 | $450.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.68 / $430.47 / $462.45
| Professional | | $372.68 | $430.47 | $462.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $3,684.41 / $7,340.77
| Facility | | $912.00 | $3,684.41 | $7,340.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.45 / $508.81 / $866.00
| Professional | | $367.45 | $508.81 | $866.00 |