- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.00 / $2,733.00 / $4,712.00
| Facility | | $1,758.00 | $2,733.00 | $4,712.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.64 / $562.13 / $912.50
| Professional | | $477.64 | $562.13 | $912.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.95 / $5,508.58 / $19,078.05
| Facility | | $1,312.95 | $5,508.58 | $19,078.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.67 / $970.72 / $4,216.56
| Professional | | $586.67 | $970.72 | $4,216.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $770.86 / $1,142.98 / $1,548.34
| Professional | | $770.86 | $1,142.98 | $1,548.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.21 / $917.47 / $1,653.63
| Professional | | $601.21 | $917.47 | $1,653.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.01 / $1,270.88 / $6,679.00
| Facility | | $586.01 | $1,270.88 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.45 / $814.55 / $1,118.36
| Professional | | $672.45 | $814.55 | $1,118.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $727.86 / $1,442.91 / $1,903.43
| Professional | | $727.86 | $1,442.91 | $1,903.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,089.00 / $4,089.00 / $4,089.00
| Facility | | $4,089.00 | $4,089.00 | $4,089.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.28 / $501.28 / $501.28
| Professional | | $501.28 | $501.28 | $501.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $6,078.00 / $26,542.00
| Facility | | $2,386.00 | $6,078.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $612.59 / $1,074.71 / $4,216.56
| Professional | | $612.59 | $1,074.71 | $4,216.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $13,017.00
| Facility | | $2,386.00 | $5,904.00 | $13,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.05 / $891.23 / $1,714.95
| Professional | | $603.05 | $891.23 | $1,714.95 |