- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,924.00 / $2,747.00 / $5,048.00
| Facility | | $1,924.00 | $2,747.00 | $5,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.50 / $329.91 / $826.06
| Professional | | $284.50 | $329.91 | $826.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.54 / $2,826.85 / $8,498.00
| Facility | | $775.54 | $2,826.85 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.81 / $546.87 / $3,727.24
| Professional | | $312.81 | $546.87 | $3,727.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.11 / $647.09 / $873.87
| Professional | | $468.11 | $647.09 | $873.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.89 / $517.99 / $915.10
| Professional | | $336.89 | $517.99 | $915.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.41 / $717.26 / $6,679.00
| Facility | | $328.41 | $717.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.85 / $457.25 / $631.19
| Professional | | $376.85 | $457.25 | $631.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.28 / $801.44 / $1,057.23
| Professional | | $404.28 | $801.44 | $1,057.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,182.91 / $2,482.48 / $5,142.85
| Facility | | $2,182.91 | $2,482.48 | $5,142.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $494.72 / $507.26 / $786.61
| Professional | | $494.72 | $507.26 | $786.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,208.11 / $3,592.00 / $26,542.00
| Facility | | $1,208.11 | $3,592.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.98 / $591.15 / $3,727.24
| Professional | | $339.98 | $591.15 | $3,727.24 |
- 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
- $325.17 / $494.77 / $1,006.90
| Professional | | $325.17 | $494.77 | $1,006.90 |