- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,919.00 / $5,980.00 / $16,973.00
| Facility | | $1,919.00 | $5,980.00 | $16,973.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.84 / $560.38 / $3,394.47
| Professional | | $466.84 | $560.38 | $3,394.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,160.00 / $5,944.00 / $13,697.00
| Facility | | $2,160.00 | $5,944.00 | $13,697.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.28 / $657.18 / $1,346.01
| Professional | | $477.28 | $657.18 | $1,346.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $5,487.90
| Facility | | $66.00 | $100.00 | $5,487.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.16 / $540.49 / $1,317.55
| Professional | | $372.16 | $540.49 | $1,317.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.75 / $717.76 / $1,716.78
| Professional | | $524.75 | $717.76 | $1,716.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $772.14 / $849.35 / $1,042.39
| Professional | | $772.14 | $849.35 | $1,042.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.33 / $838.78 / $1,537.76
| Professional | | $610.33 | $838.78 | $1,537.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $6,817.20
| Facility | | $55.00 | $55.00 | $6,817.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,716.32 / $4,801.92 / $5,576.55
| Professional | | $4,716.32 | $4,801.92 | $5,576.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.66 / $782.86 / $1,043.81
| Facility | | $579.66 | $782.86 | $1,043.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.38 / $734.83 / $1,656.47
| Professional | | $538.38 | $734.83 | $1,656.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,106.21 / $2,106.21 / $2,106.21
| Professional | | $2,106.21 | $2,106.21 | $2,106.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,348.00 / $4,243.00 / $9,131.00
| Facility | | $2,348.00 | $4,243.00 | $9,131.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.85 / $611.49 / $1,398.03
| Professional | | $461.85 | $611.49 | $1,398.03 |