- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.45 / $3,589.00 / $8,240.00
| Facility | | $467.45 | $3,589.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.36 / $467.45 / $715.73
| Professional | | $400.36 | $467.45 | $715.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,463.00 / $11,091.00
| Facility | | $4,150.00 | $7,463.00 | $11,091.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.96 / $453.45 / $453.45
| Professional | | $436.96 | $453.45 | $453.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.45 / $501.45 / $501.45
| Facility | | $501.45 | $501.45 | $501.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.15 / $555.85 / $908.32
| Professional | | $425.15 | $555.85 | $908.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $522.66 / $699.27 / $902.79
| Professional | | $522.66 | $699.27 | $902.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,560.45 / $7,560.45 / $8,611.28
| Facility | | $7,560.45 | $7,560.45 | $8,611.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.00 / $4,534.00 / $8,404.00
| Facility | | $926.00 | $4,534.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.20 / $502.92 / $2,328.19
| Professional | | $409.20 | $502.92 | $2,328.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.90 / $352.90 / $1,015.70
| Professional | | $352.90 | $352.90 | $1,015.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.45 / $501.45 / $501.45
| Facility | | $501.45 | $501.45 | $501.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.15 / $557.21 / $940.83
| Professional | | $425.15 | $557.21 | $940.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.56 / $433.56 / $452.38
| Facility | | $433.56 | $433.56 | $452.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.23 / $433.56 / $465.03
| Professional | | $425.23 | $433.56 | $465.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.92 / $538.73 / $862.61
| Professional | | $381.92 | $538.73 | $862.61 |