- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.82 / $1,245.00 / $8,413.00
| Facility | | $439.82 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.94 / $464.77 / $891.18
| Professional | | $422.94 | $464.77 | $891.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.63 / $765.73 / $1,268.60
| Professional | | $557.63 | $765.73 | $1,268.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.07 / $683.89 / $1,125.24
| Professional | | $506.07 | $683.89 | $1,125.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.82 / $615.75 / $993.99
| Facility | | $439.82 | $615.75 | $993.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.80 / $556.00 / $606.00
| Professional | | $555.80 | $556.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $603.50 / $1,212.40
| Professional | | $3.00 | $603.50 | $1,212.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.41 / $561.48 / $1,062.66
| Professional | | $392.41 | $561.48 | $1,062.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,705.48 / $8,957.00 / $26,542.00
| Facility | | $1,705.48 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,139.31 / $4,139.31 / $4,139.31
| Professional | | $4,139.31 | $4,139.31 | $4,139.31 |