- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.19 / $1,181.00 / $7,439.00
| Facility | | $496.19 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.19 / $523.16 / $1,004.52
| Professional | | $496.19 | $523.16 | $1,004.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.62 / $829.12 / $1,329.52
| Professional | | $468.62 | $829.12 | $1,329.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.16 / $717.15 / $1,250.26
| Professional | | $532.16 | $717.15 | $1,250.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.19 / $681.18 / $992.76
| Facility | | $496.19 | $681.18 | $992.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $620.00 / $666.00
| Professional | | $507.00 | $620.00 | $666.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $680.40 / $1,324.70
| Professional | | $5.00 | $680.40 | $1,324.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.34 / $626.40 / $1,372.03
| Professional | | $434.34 | $626.40 | $1,372.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,885.70 / $8,957.00 / $16,394.00
| Facility | | $2,885.70 | $8,957.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,722.56 / $3,722.56 / $4,434.45
| Professional | | $3,722.56 | $3,722.56 | $4,434.45 |