- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.06 / $3,015.88 / $7,284.22
| Facility | | $849.06 | $3,015.88 | $7,284.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.08 / $734.87 / $1,383.65
| Professional | | $557.08 | $734.87 | $1,383.65 |
- 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
- $594.39 / $800.77 / $1,126.04
| Professional | | $594.39 | $800.77 | $1,126.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $695.17 / $695.17 / $3,426.00
| Professional | | $695.17 | $695.17 | $3,426.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.84 / $1,051.84 / $1,051.84
| Facility | | $1,051.84 | $1,051.84 | $1,051.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.11 / $816.40 / $1,435.46
| Professional | | $610.11 | $816.40 | $1,435.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $802.44 / $891.63 / $1,061.46
| Professional | | $802.44 | $891.63 | $1,061.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.03 / $803.48 / $1,155.15
| Facility | | $598.03 | $803.48 | $1,155.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.00 / $1,071.00 / $1,509.00
| Professional | | $907.00 | $1,071.00 | $1,509.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.24 / $831.06 / $3,123.00
| Facility | | $624.24 | $831.06 | $3,123.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $699.73 / $951.63 / $3,265.30
| Professional | | $699.73 | $951.63 | $3,265.30 |
- 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
- $583.16 / $794.25 / $1,346.80
| Professional | | $583.16 | $794.25 | $1,346.80 |