- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.51 / $2,547.00 / $3,625.00
| Facility | | $293.51 | $2,547.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.03 / $311.43 / $681.74
| Professional | | $192.03 | $311.43 | $681.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.44 / $947.00 / $3,445.00
| Facility | | $567.44 | $947.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.07 / $564.53 / $1,741.12
| Professional | | $264.07 | $564.53 | $1,741.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.00 / $369.20 / $651.50
| Facility | | $284.00 | $369.20 | $651.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.05 / $593.64 / $976.09
| Professional | | $370.05 | $593.64 | $976.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.64 / $557.14 / $1,185.30
| Professional | | $302.64 | $557.14 | $1,185.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.95 / $517.84 / $6,679.00
| Facility | | $244.95 | $517.84 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.47 / $546.35 / $754.18
| Professional | | $431.47 | $546.35 | $754.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.01 / $631.47 / $1,052.17
| Professional | | $299.01 | $631.47 | $1,052.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.98 / $1,191.79 / $2,941.55
| Facility | | $586.98 | $1,191.79 | $2,941.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $690.23 / $690.23 / $690.23
| Professional | | $690.23 | $690.23 | $690.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $16,394.00
| Facility | | $627.00 | $1,818.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.33 / $718.76 / $2,786.08
| Professional | | $382.33 | $718.76 | $2,786.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.78 / $565.90 / $1,171.75
| Professional | | $342.78 | $565.90 | $1,171.75 |