- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.54 / $2,422.00 / $7,799.00
| Facility | | $603.54 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.57 / $562.82 / $754.86
| Professional | | $481.57 | $562.82 | $754.86 |
- 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
- $540.97 / $561.39 / $953.66
| Professional | | $540.97 | $561.39 | $953.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.00 / $358.00 / $358.00
| Facility | | $358.00 | $358.00 | $358.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.04 / $551.22 / $892.39
| Professional | | $428.04 | $551.22 | $892.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $657.93 / $657.93 / $848.42
| Professional | | $657.93 | $657.93 | $848.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,371.00 / $8,017.00
| Facility | | $641.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.43 / $641.00 / $2,889.20
| Professional | | $498.43 | $641.00 | $2,889.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.60 / $502.60 / $970.30
| Professional | | $502.60 | $502.60 | $970.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.00 / $358.00 / $358.00
| Facility | | $358.00 | $358.00 | $358.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.20 / $567.19 / $892.39
| Professional | | $430.20 | $567.19 | $892.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $449.04 / $534.50 / $534.50
| Facility | | $449.04 | $534.50 | $534.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.04 / $534.50 / $570.15
| Professional | | $449.04 | $534.50 | $570.15 |
- 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
- $452.25 / $582.45 / $1,032.77
| Professional | | $452.25 | $582.45 | $1,032.77 |