- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.04 / $4,376.00 / $7,278.00
| Facility | | $438.04 | $4,376.00 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.62 / $462.23 / $1,217.80
| Professional | | $380.62 | $462.23 | $1,217.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.17 / $235.17 / $235.17
| Professional | | $235.17 | $235.17 | $235.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.77 / $709.35 / $1,173.36
| Professional | | $502.77 | $709.35 | $1,173.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,438.74
| Facility | | $530.04 | $530.04 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.49 / $633.03 / $1,098.25
| Professional | | $475.49 | $633.03 | $1,098.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.04 / $526.62 / $989.97
| Facility | | $438.04 | $526.62 | $989.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $548.00 / $600.00
| Professional | | $507.00 | $548.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $605.60 / $1,180.09
| Professional | | $3.00 | $605.60 | $1,180.09 |
- 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
- $371.08 / $516.58 / $1,074.53
| Professional | | $371.08 | $516.58 | $1,074.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,705.60 / $4,754.80 / $16,394.00
| Facility | | $1,705.60 | $4,754.80 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,924.90 / $4,514.43 / $4,514.43
| Professional | | $3,924.90 | $4,514.43 | $4,514.43 |