- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,508.00 / $4,043.00 / $9,661.00
| Facility | | $1,508.00 | $4,043.00 | $9,661.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.05 / $254.58 / $321.76
| Professional | | $180.05 | $254.58 | $321.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,977.00 / $9,808.00 / $16,411.00
| Facility | | $4,977.00 | $9,808.00 | $16,411.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.50 / $230.39 / $392.17
| Professional | | $192.50 | $230.39 | $392.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.02 / $283.02 / $283.02
| Facility | | $283.02 | $283.02 | $283.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.47 / $1,178.68 / $1,178.68
| Professional | | $236.47 | $1,178.68 | $1,178.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.68 / $369.68 / $369.68
| Professional | | $369.68 | $369.68 | $369.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.53 / $232.53 / $232.53
| Facility | | $232.53 | $232.53 | $232.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.53 / $348.84 / $527.53
| Professional | | $232.53 | $348.84 | $527.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.02 / $555.00 / $597.00
| Facility | | $283.02 | $555.00 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.47 / $1,178.68 / $1,178.68
| Professional | | $236.47 | $1,178.68 | $1,178.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,341.00 / $6,700.00 / $16,782.00
| Facility | | $2,341.00 | $6,700.00 | $16,782.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.66 / $361.91 / $800.39
| Professional | | $232.66 | $361.91 | $800.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.53 / $239.24 / $239.24
| Facility | | $232.53 | $239.24 | $239.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.24 / $239.24 / $527.53
| Professional | | $239.24 | $239.24 | $527.53 |