- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.89 / $3,325.00 / $10,635.00
| Facility | | $535.89 | $3,325.00 | $10,635.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.63 / $360.38 / $709.58
| Professional | | $307.63 | $360.38 | $709.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,792.00 / $8,800.00
| Facility | | $1,145.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.38 / $473.11 / $817.19
| Professional | | $325.38 | $473.11 | $817.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.70 / $424.43 / $563.70
| Facility | | $330.70 | $424.43 | $563.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.06 / $495.17 / $127,498.73
| Professional | | $389.06 | $495.17 | $127,498.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.69 / $502.16 / $740.21
| Professional | | $353.69 | $502.16 | $740.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.66 / $426.66 / $426.66
| Facility | | $426.66 | $426.66 | $426.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.94 / $512.85 / $746.11
| Professional | | $349.94 | $512.85 | $746.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.85 / $262.33 / $435.49
| Professional | | $34.85 | $262.33 | $435.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,223.00 / $6,522.00
| Facility | | $2,233.00 | $4,223.00 | $6,522.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.24 / $460.93 / $717.10
| Professional | | $302.24 | $460.93 | $717.10 |