- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.48 / $1,245.00 / $8,413.00
| Facility | | $467.48 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.48 / $491.81 / $878.12
| Professional | | $467.48 | $491.81 | $878.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.46 / $694.61 / $1,245.99
| Professional | | $398.46 | $694.61 | $1,245.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.73 / $635.13 / $1,098.16
| Professional | | $476.73 | $635.13 | $1,098.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.48 / $547.02 / $889.50
| Facility | | $467.48 | $547.02 | $889.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $547.02 / $565.00 / $630.00
| Professional | | $547.02 | $565.00 | $630.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $644.29 / $1,081.00
| Professional | | $4.00 | $644.29 | $1,081.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.94 / $546.88 / $1,142.49
| Professional | | $392.94 | $546.88 | $1,142.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $7,817.95 / $8,957.00
| Facility | | $2,000.00 | $7,817.95 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,522.96 / $3,522.96 / $4,192.20
| Professional | | $3,522.96 | $3,522.96 | $4,192.20 |