- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.83 / $2,190.00 / $8,294.00
| Facility | | $601.83 | $2,190.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.65 / $564.45 / $772.87
| Professional | | $476.65 | $564.45 | $772.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.47 / $617.79 / $1,021.40
| Professional | | $477.47 | $617.79 | $1,021.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.23 / $625.54 / $2,012.00
| Professional | | $581.23 | $625.54 | $2,012.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.00 / $420.00 / $876.58
| Facility | | $420.00 | $420.00 | $876.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.90 / $667.07 / $1,207.73
| Professional | | $512.90 | $667.07 | $1,207.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.73 / $710.17 / $839.29
| Professional | | $549.73 | $710.17 | $839.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.39 / $674.51 / $1,015.76
| Facility | | $500.39 | $674.51 | $1,015.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.00 / $757.00 / $1,076.00
| Professional | | $673.00 | $757.00 | $1,076.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.11 / $633.44 / $1,204.04
| Facility | | $495.11 | $633.44 | $1,204.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.65 / $688.15 / $1,316.08
| Professional | | $534.65 | $688.15 | $1,316.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.00 / $1,045.00 / $2,364.00
| Facility | | $231.00 | $1,045.00 | $2,364.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.81 / $665.30 / $1,044.05
| Professional | | $418.81 | $665.30 | $1,044.05 |