- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.03 / $474.24 / $581.39
| Professional | | $422.03 | $474.24 | $581.39 |
- 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
- $465.37 / $547.49 / $853.43
| Professional | | $465.37 | $547.49 | $853.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.59 / $658.39 / $1,014.22
| Professional | | $499.59 | $658.39 | $1,014.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.58 / $831.02 / $836.33
| Professional | | $626.58 | $831.02 | $836.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,811.91 / $8,811.91 / $8,811.91
| Facility | | $8,811.91 | $8,811.91 | $8,811.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.03 / $493.03 / $1,544.00
| Professional | | $422.03 | $493.03 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $1,212.50
| Professional | | $5.00 | $5.00 | $1,212.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.59 / $659.29 / $1,148.09
| Professional | | $499.59 | $659.29 | $1,148.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.82 / $521.02 / $521.02
| Facility | | $515.82 | $521.02 | $521.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.30 / $521.02 / $551.96
| Professional | | $507.30 | $521.02 | $551.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,476.00 / $10,443.12
| Facility | | $2,332.00 | $4,476.00 | $10,443.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.62 / $601.82 / $972.23
| Professional | | $465.62 | $601.82 | $972.23 |