- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $793.66 / $5,087.00 / $8,294.00
| Facility | | $793.66 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.92 / $729.60 / $925.57
| Professional | | $627.92 | $729.60 | $925.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $632.54 / $826.87 / $1,367.06
| Professional | | $632.54 | $826.87 | $1,367.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $775.62 / $787.11 / $4,117.00
| Professional | | $775.62 | $787.11 | $4,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $791.21
| Facility | | $640.00 | $640.00 | $791.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.29 / $834.69 / $1,541.83
| Professional | | $532.29 | $834.69 | $1,541.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $670.09 / $857.72 / $1,008.27
| Professional | | $670.09 | $857.72 | $1,008.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.28 / $852.37 / $1,324.82
| Facility | | $605.28 | $852.37 | $1,324.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.00 / $938.00 / $1,386.00
| Professional | | $627.00 | $938.00 | $1,386.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.07 / $844.53 / $1,716.73
| Facility | | $469.07 | $844.53 | $1,716.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.07 / $844.53 / $1,716.73
| Professional | | $469.07 | $844.53 | $1,716.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,713.00 / $3,175.00 / $5,584.86
| Facility | | $1,713.00 | $3,175.00 | $5,584.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.37 / $706.08 / $1,348.91
| Professional | | $394.37 | $706.08 | $1,348.91 |