- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.98 / $2,618.00 / $4,806.64
| Facility | | $431.98 | $2,618.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.23 / $437.52 / $960.61
| Professional | | $298.23 | $437.52 | $960.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $806.57 / $2,854.00 / $9,039.00
| Facility | | $806.57 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.47 / $783.03 / $3,504.40
| Professional | | $379.47 | $783.03 | $3,504.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.28 / $525.91 / $938.89
| Facility | | $409.28 | $525.91 | $938.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $671.14 / $976.16 / $1,015.83
| Professional | | $671.14 | $976.16 | $1,015.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.06 / $711.94 / $1,305.58
| Professional | | $403.06 | $711.94 | $1,305.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.86 / $746.26 / $6,679.00
| Facility | | $342.86 | $746.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.91 / $690.45 / $955.19
| Professional | | $565.91 | $690.45 | $955.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.57 / $932.64 / $1,410.06
| Professional | | $445.57 | $932.64 | $1,410.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.24 / $2,941.55 / $3,394.78
| Facility | | $839.24 | $2,941.55 | $3,394.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.66 / $517.82 / $1,065.28
| Professional | | $489.66 | $517.82 | $1,065.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $16,394.00
| Facility | | $1,902.00 | $3,764.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.68 / $972.09 / $3,504.40
| Professional | | $484.68 | $972.09 | $3,504.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.75 / $713.67 / $1,482.17
| Professional | | $466.75 | $713.67 | $1,482.17 |