- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.14 / $2,663.12 / $4,766.57
| Facility | | $309.14 | $2,663.12 | $4,766.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.65 / $361.61 / $669.40
| Professional | | $233.65 | $361.61 | $669.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.44 / $2,854.00 / $9,039.00
| Facility | | $705.44 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.80 / $619.96 / $2,093.60
| Professional | | $310.80 | $619.96 | $2,093.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.97 / $439.36 / $775.30
| Facility | | $337.97 | $439.36 | $775.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.63 / $674.59 / $1,007.03
| Professional | | $458.63 | $674.59 | $1,007.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.16 / $553.85 / $1,168.20
| Professional | | $328.16 | $553.85 | $1,168.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.88 / $616.26 / $6,679.00
| Facility | | $292.88 | $616.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.50 / $563.67 / $778.10
| Professional | | $448.50 | $563.67 | $778.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.40 / $754.18 / $1,201.79
| Professional | | $358.40 | $754.18 | $1,201.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.71 / $524.71 / $1,517.53
| Facility | | $524.71 | $524.71 | $1,517.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.00 / $605.00 / $605.00
| Professional | | $605.00 | $605.00 | $605.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $16,394.00
| Facility | | $1,902.00 | $3,764.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.21 / $767.81 / $2,919.12
| Professional | | $436.21 | $767.81 | $2,919.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.76 / $563.80 / $1,252.97
| Professional | | $348.76 | $563.80 | $1,252.97 |