- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $806.00 / $2,371.00 / $7,799.00
| Facility | | $806.00 | $2,371.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $752.45 / $821.35 / $1,070.05
| Professional | | $752.45 | $821.35 | $1,070.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.19 / $1,188.57 / $1,606.16
| Professional | | $728.19 | $1,188.57 | $1,606.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $799.40 / $1,081.04 / $1,707.67
| Professional | | $799.40 | $1,081.04 | $1,707.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $984.78 / $1,306.43 / $1,318.04
| Professional | | $984.78 | $1,306.43 | $1,318.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,147.41 / $1,147.41 / $1,147.41
| Facility | | $1,147.41 | $1,147.41 | $1,147.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,371.00 / $8,017.00
| Facility | | $657.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $733.97 / $861.13 / $2,256.66
| Professional | | $733.97 | $861.13 | $2,256.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $955.50 / $2,193.10
| Professional | | $5.00 | $955.50 | $2,193.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $806.71 / $1,081.04 / $1,802.71
| Professional | | $806.71 | $1,081.04 | $1,802.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.21 / $824.21 / $927.72
| Facility | | $824.21 | $824.21 | $927.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $804.16 / $824.21 / $927.72
| Professional | | $804.16 | $824.21 | $927.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $737.85 / $990.27 / $1,636.70
| Professional | | $737.85 | $990.27 | $1,636.70 |