- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.40 / $4,304.00 / $8,247.00
| Facility | | $884.40 | $4,304.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.70 / $824.48 / $1,109.17
| Professional | | $706.70 | $824.48 | $1,109.17 |
- 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
- $792.64 / $822.55 / $1,365.90
| Professional | | $792.64 | $822.55 | $1,365.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.05 / $808.62 / $1,369.55
| Professional | | $627.05 | $808.62 | $1,369.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $957.88 / $957.88 / $1,235.21
| Professional | | $957.88 | $957.88 | $1,235.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,404.00
| Facility | | $1,013.00 | $4,761.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.00 / $947.25 / $4,839.46
| Professional | | $750.00 | $947.25 | $4,839.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $723.70 / $723.70 / $723.70
| Professional | | $723.70 | $723.70 | $723.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.16 / $822.95 / $1,369.55
| Professional | | $631.16 | $822.95 | $1,369.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.72 / $784.07 / $784.07
| Facility | | $644.72 | $784.07 | $784.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.72 / $784.07 / $833.59
| Professional | | $644.72 | $784.07 | $833.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.00 / $3,475.00 / $6,368.00
| Facility | | $1,440.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.29 / $843.85 / $1,449.78
| Professional | | $640.29 | $843.85 | $1,449.78 |