- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,196.00 / $4,518.60 / $13,841.56
| Facility | | $2,196.00 | $4,518.60 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.01 / $292.54 / $1,170.59
| Professional | | $209.01 | $292.54 | $1,170.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.01 / $548.24 / $685.05
| Professional | | $246.01 | $548.24 | $685.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,422.95 / $4,502.10 / $8,708.54
| Facility | | $3,422.95 | $4,502.10 | $8,708.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.75 / $397.85 / $584.66
| Professional | | $220.75 | $397.85 | $584.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.55 / $690.68 / $913.92
| Professional | | $260.55 | $690.68 | $913.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.48 / $511.95 / $2,398.48
| Facility | | $247.48 | $511.95 | $2,398.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.00 / $648.67 / $2,345.12
| Professional | | $376.00 | $648.67 | $2,345.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.89 / $568.07 / $796.25
| Facility | | $320.89 | $568.07 | $796.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.66 / $601.97 / $838.29
| Professional | | $446.66 | $601.97 | $838.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.67 / $395.93 / $632.59
| Professional | | $237.67 | $395.93 | $632.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.00 / $688.61 / $755.63
| Professional | | $376.00 | $688.61 | $755.63 |