- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.26 / $667.12 / $1,108.35
| Professional | | $610.26 | $667.12 | $1,108.35 |
- 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
- $597.58 / $945.86 / $1,276.88
| Professional | | $597.58 | $945.86 | $1,276.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.77 / $862.82 / $1,414.32
| Professional | | $629.77 | $862.82 | $1,414.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.34 / $1,077.74 / $1,092.01
| Professional | | $812.34 | $1,077.74 | $1,092.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,321.75 / $11,321.75 / $18,722.43
| Facility | | $11,321.75 | $11,321.75 | $18,722.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.05 / $767.78 / $2,229.96
| Professional | | $620.05 | $767.78 | $2,229.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $736.40 / $1,827.70
| Professional | | $5.00 | $736.40 | $1,827.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $664.81 / $894.40 / $1,434.82
| Professional | | $664.81 | $894.40 | $1,434.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.74 / $679.18 / $679.18
| Facility | | $677.74 | $679.18 | $679.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $664.22 / $679.18 / $725.08
| Professional | | $664.22 | $679.18 | $725.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $594.26 / $852.91 / $1,338.91
| Professional | | $594.26 | $852.91 | $1,338.91 |