- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.61 / $1,245.00 / $10,561.00
| Facility | | $544.61 | $1,245.00 | $10,561.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.16 / $551.57 / $1,023.72
| Professional | | $475.16 | $551.57 | $1,023.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.31 / $1,326.31 / $1,345.66
| Facility | | $1,326.31 | $1,326.31 | $1,345.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.38 / $800.63 / $1,448.59
| Professional | | $548.38 | $800.63 | $1,448.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $1,438.74
| Facility | | $748.70 | $748.70 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.34 / $729.58 / $1,350.79
| Professional | | $544.34 | $729.58 | $1,350.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.00 / $645.86 / $1,015.92
| Facility | | $533.00 | $645.86 | $1,015.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.86 / $676.00 / $749.00
| Professional | | $645.86 | $676.00 | $749.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $753.70 / $1,484.00
| Professional | | $3.00 | $753.70 | $1,484.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.25 / $644.66 / $1,461.97
| Professional | | $460.25 | $644.66 | $1,461.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,125.32 / $4,754.80 / $26,542.00
| Facility | | $2,125.32 | $4,754.80 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,113.68 / $4,113.68 / $4,902.89
| Professional | | $4,113.68 | $4,113.68 | $4,902.89 |