- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.97 / $2,581.76 / $4,186.37
| Facility | | $482.97 | $2,581.76 | $4,186.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.89 / $499.10 / $969.42
| Professional | | $309.89 | $499.10 | $969.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $805.47 / $2,376.00 / $8,498.00
| Facility | | $805.47 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.31 / $905.98 / $3,944.88
| Professional | | $403.31 | $905.98 | $3,944.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.97 / $525.53 / $938.18
| Facility | | $408.97 | $525.53 | $938.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $577.66 / $858.91 / $1,343.57
| Professional | | $577.66 | $858.91 | $1,343.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.49 / $753.61 / $1,410.24
| Professional | | $424.49 | $753.61 | $1,410.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.54 / $745.72 / $6,679.00
| Facility | | $342.54 | $745.72 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $638.02 / $778.41 / $1,080.08
| Professional | | $638.02 | $778.41 | $1,080.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.28 / $934.16 / $1,589.54
| Professional | | $444.28 | $934.16 | $1,589.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $995.10 / $3,050.05 / $4,320.31
| Facility | | $995.10 | $3,050.05 | $4,320.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.09 / $706.20 / $1,168.44
| Professional | | $480.09 | $706.20 | $1,168.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $16,394.00
| Facility | | $1,640.00 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.01 / $1,233.55 / $3,944.88
| Professional | | $660.01 | $1,233.55 | $3,944.88 |
- 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
- $623.15 / $911.06 / $1,706.25
| Professional | | $623.15 | $911.06 | $1,706.25 |