- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.36 / $2,663.12 / $4,553.00
| Facility | | $305.36 | $2,663.12 | $4,553.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.56 / $396.85 / $1,053.96
| Professional | | $227.56 | $396.85 | $1,053.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.89 / $1,052.09 / $3,445.00
| Facility | | $585.89 | $1,052.09 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.97 / $581.88 / $1,787.60
| Professional | | $270.97 | $581.88 | $1,787.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.39 / $377.52 / $666.18
| Facility | | $290.39 | $377.52 | $666.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.07 / $631.82 / $990.25
| Professional | | $394.07 | $631.82 | $990.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.27 / $603.97 / $1,238.34
| Professional | | $314.27 | $603.97 | $1,238.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.21 / $529.52 / $6,679.00
| Facility | | $250.21 | $529.52 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.54 / $554.28 / $765.12
| Professional | | $437.54 | $554.28 | $765.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.10 / $642.57 / $1,072.02
| Professional | | $303.10 | $642.57 | $1,072.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.88 / $1,017.46 / $4,065.76
| Facility | | $536.88 | $1,017.46 | $4,065.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.04 / $639.91 / $1,318.78
| Professional | | $312.04 | $639.91 | $1,318.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $26,542.00
| Facility | | $627.00 | $1,818.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.00 / $747.01 / $2,834.96
| Professional | | $389.00 | $747.01 | $2,834.96 |
- 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
- $308.07 / $561.74 / $1,085.42
| Professional | | $308.07 | $561.74 | $1,085.42 |