- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.04 / $2,547.00 / $3,869.27
| Facility | | $599.04 | $2,547.00 | $3,869.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.07 / $455.50 / $885.70
| Professional | | $292.07 | $455.50 | $885.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.09 / $2,376.00 / $8,498.00
| Facility | | $761.09 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.92 / $817.88 / $3,689.92
| Professional | | $373.92 | $817.88 | $3,689.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.69 / $493.04 / $880.18
| Facility | | $383.69 | $493.04 | $880.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.70 / $834.79 / $1,304.81
| Professional | | $571.70 | $834.79 | $1,304.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.74 / $726.42 / $1,390.82
| Professional | | $400.74 | $726.42 | $1,390.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.12 / $699.62 / $6,679.00
| Facility | | $322.12 | $699.62 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $596.47 / $727.72 / $1,008.18
| Professional | | $596.47 | $727.72 | $1,008.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.33 / $881.71 / $1,494.07
| Professional | | $419.33 | $881.71 | $1,494.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,609.51 / $2,288.98 / $3,274.02
| Facility | | $1,609.51 | $2,288.98 | $3,274.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.25 / $691.00 / $3,432.16
| Professional | | $478.25 | $691.00 | $3,432.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.24 / $3,372.00 / $16,394.00
| Facility | | $1,634.24 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.57 / $1,046.81 / $3,689.92
| Professional | | $491.57 | $1,046.81 | $3,689.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.40 / $747.42 / $2,214.27
| Professional | | $457.40 | $747.42 | $2,214.27 |