- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $3,224.00 / $11,453.00
| Facility | | $767.00 | $3,224.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.91 / $627.62 / $1,067.71
| Professional | | $549.91 | $627.62 | $1,067.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.16 / $881.91 / $1,567.41
| Professional | | $575.16 | $881.91 | $1,567.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $569.34 / $577.60
| Facility | | $80.00 | $569.34 | $577.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.92 / $704.92 / $704.92
| Facility | | $704.92 | $704.92 | $704.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.03 / $832.88 / $1,260.51
| Professional | | $609.03 | $832.88 | $1,260.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,327.08 / $11,500.00 / $26,542.00
| Facility | | $2,327.08 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,247.92 / $5,358.30 / $5,421.10
| Professional | | $5,247.92 | $5,358.30 | $5,421.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.79 / $821.94 / $1,270.34
| Facility | | $577.79 | $821.94 | $1,270.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $766.21 / $919.46 / $1,140.11
| Professional | | $766.21 | $919.46 | $1,140.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,017.17 / $1,184.03 / $2,332.05
| Professional | | $1,017.17 | $1,184.03 | $2,332.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.79 / $829.11 / $1,346.70
| Facility | | $579.79 | $829.11 | $1,346.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.78 / $874.20 / $1,291.43
| Professional | | $629.78 | $874.20 | $1,291.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.36 / $654.49 / $1,064.70
| Professional | | $479.36 | $654.49 | $1,064.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.15 / $593.05 / $825.35
| Professional | | $523.15 | $593.05 | $825.35 |