- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.40 / $521.95 / $715.65
| Professional | | $455.40 | $521.95 | $715.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.53 / $561.97 / $945.36
| Professional | | $541.53 | $561.97 | $945.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.63 / $615.63 / $615.63
| Facility | | $615.63 | $615.63 | $615.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.60 / $603.94 / $1,011.44
| Professional | | $421.60 | $603.94 | $1,011.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.41 / $872.83 / $1,114.81
| Professional | | $645.41 | $872.83 | $1,114.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.10 / $709.10 / $709.10
| Facility | | $709.10 | $709.10 | $709.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.62 / $601.62 / $601.62
| Professional | | $601.62 | $601.62 | $601.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.77 / $583.39 / $2,765.19
| Professional | | $479.77 | $583.39 | $2,765.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.60 / $533.60 / $1,049.40
| Professional | | $533.60 | $533.60 | $1,049.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.63 / $615.63 / $615.63
| Facility | | $615.63 | $615.63 | $615.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.87 / $610.10 / $1,038.52
| Professional | | $453.87 | $610.10 | $1,038.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.90 / $523.91 / $523.91
| Facility | | $461.90 | $523.91 | $523.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.90 / $523.91 / $558.80
| Professional | | $461.90 | $523.91 | $558.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.24 / $631.39 / $1,038.83
| Professional | | $447.24 | $631.39 | $1,038.83 |