- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,048.00 / $8,451.00
| Facility | | $1,020.00 | $4,048.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.02 / $686.71 / $1,005.45
| Professional | | $613.02 | $686.71 | $1,005.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.60 / $730.32 / $1,238.09
| Professional | | $687.60 | $730.32 | $1,238.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $778.19 / $778.19 / $778.19
| Facility | | $778.19 | $778.19 | $778.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $638.07 / $824.48 / $1,378.59
| Professional | | $638.07 | $824.48 | $1,378.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $814.72 / $1,104.16 / $1,407.24
| Professional | | $814.72 | $1,104.16 | $1,407.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.00 / $4,993.00 / $10,247.00
| Facility | | $1,151.00 | $4,993.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $617.50 / $732.52 / $2,843.00
| Professional | | $617.50 | $732.52 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $849.70 / $849.70 / $1,397.00
| Professional | | $849.70 | $849.70 | $1,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $778.19 / $778.19 / $778.19
| Facility | | $778.19 | $778.19 | $778.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $638.29 / $853.61 / $1,405.45
| Professional | | $638.29 | $853.61 | $1,405.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.78 / $667.78 / $716.10
| Facility | | $667.78 | $667.78 | $716.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $647.52 / $670.76 / $716.10
| Professional | | $647.52 | $670.76 | $716.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.26 / $820.79 / $1,369.01
| Professional | | $637.26 | $820.79 | $1,369.01 |