- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $777.13 / $3,988.00 / $8,294.00
| Facility | | $777.13 | $3,988.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.56 / $636.02 / $1,036.14
| Professional | | $495.56 | $636.02 | $1,036.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.39 / $731.15 / $1,043.49
| Professional | | $541.39 | $731.15 | $1,043.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.53 / $626.53 / $3,426.00
| Professional | | $626.53 | $626.53 | $3,426.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.38 / $953.38 / $953.38
| Facility | | $953.38 | $953.38 | $953.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.17 / $746.84 / $1,320.37
| Professional | | $549.17 | $746.84 | $1,320.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.98 / $828.39 / $986.18
| Professional | | $741.98 | $828.39 | $986.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.62 / $733.49 / $1,039.64
| Facility | | $540.62 | $733.49 | $1,039.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $826.00 / $983.00 / $1,383.00
| Professional | | $826.00 | $983.00 | $1,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.35 / $742.12 / $3,147.19
| Facility | | $544.35 | $742.12 | $3,147.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.91 / $878.37 / $3,236.71
| Professional | | $631.91 | $878.37 | $3,236.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,911.00 / $3,175.00 / $5,340.00
| Facility | | $1,911.00 | $3,175.00 | $5,340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $528.36 / $727.27 / $1,268.55
| Professional | | $528.36 | $727.27 | $1,268.55 |