- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.06 / $2,474.61 / $3,693.00
| Facility | | $398.06 | $2,474.61 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.43 / $399.63 / $1,069.18
| Professional | | $253.43 | $399.63 | $1,069.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.35 / $2,376.00 / $8,498.00
| Facility | | $764.35 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.08 / $675.54 / $2,271.76
| Professional | | $319.08 | $675.54 | $2,271.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.71 / $476.72 / $841.23
| Facility | | $366.71 | $476.72 | $841.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.74 / $797.85 / $1,165.60
| Professional | | $535.74 | $797.85 | $1,165.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.00 / $608.85 / $1,284.21
| Professional | | $352.00 | $608.85 | $1,284.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.61 / $668.66 / $6,679.00
| Facility | | $311.61 | $668.66 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.26 / $622.75 / $859.64
| Professional | | $495.26 | $622.75 | $859.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.12 / $823.77 / $1,326.79
| Professional | | $389.12 | $823.77 | $1,326.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.67 / $2,790.25 / $3,863.50
| Facility | | $615.67 | $2,790.25 | $3,863.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.55 / $687.69 / $1,086.51
| Professional | | $490.55 | $687.69 | $1,086.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,559.76 / $3,372.00 / $16,394.00
| Facility | | $1,559.76 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.03 / $849.26 / $3,221.36
| Professional | | $413.03 | $849.26 | $3,221.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.90 / $619.94 / $1,206.79
| Professional | | $351.90 | $619.94 | $1,206.79 |