- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.54 / $2,496.00 / $7,316.00
| Facility | | $456.54 | $2,496.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.81 / $392.18 / $592.49
| Professional | | $241.81 | $392.18 | $592.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.45 / $511.22 / $1,140.65
| Facility | | $286.45 | $511.22 | $1,140.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.17 / $463.45 / $652.29
| Professional | | $275.17 | $463.45 | $652.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.80 / $286.80 / $526.67
| Facility | | $286.80 | $286.80 | $526.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.33 / $490.54 / $749.02
| Professional | | $321.33 | $490.54 | $749.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,058.23 / $16,394.00 / $16,394.00
| Facility | | $2,058.23 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,166.88 / $3,579.28 / $4,233.08
| Professional | | $2,166.88 | $3,579.28 | $4,233.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.58 / $436.21 / $667.38
| Facility | | $283.58 | $436.21 | $667.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.54 / $588.05 / $903.07
| Professional | | $367.54 | $588.05 | $903.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.92 / $491.80 / $670.63
| Professional | | $313.92 | $491.80 | $670.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.58 / $436.62 / $669.60
| Facility | | $283.58 | $436.62 | $669.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.64 / $504.97 / $838.76
| Professional | | $322.64 | $504.97 | $838.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $952.00 / $2,405.00
| Facility | | $161.00 | $952.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.79 / $501.63 / $712.16
| Professional | | $366.79 | $501.63 | $712.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.38 / $466.53 / $653.14
| Professional | | $414.38 | $466.53 | $653.14 |