- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.00 / $4,796.00 / $8,294.00
| Facility | | $1,244.00 | $4,796.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.19 / $746.75 / $1,069.32
| Professional | | $643.19 | $746.75 | $1,069.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $668.74 / $855.17 / $1,413.85
| Professional | | $668.74 | $855.17 | $1,413.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $756.40 / $831.22 / $4,117.00
| Professional | | $756.40 | $831.22 | $4,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $811.26
| Facility | | $640.00 | $640.00 | $811.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $688.10 / $938.72 / $1,558.33
| Professional | | $688.10 | $938.72 | $1,558.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.37 / $884.37 / $1,045.16
| Professional | | $683.37 | $884.37 | $1,045.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $692.36 / $882.52 / $1,366.55
| Facility | | $692.36 | $882.52 | $1,366.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $846.00 / $981.35 / $1,350.00
| Professional | | $846.00 | $981.35 | $1,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $686.47 / $912.51 / $2,987.43
| Facility | | $686.47 | $912.51 | $2,987.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $686.47 / $912.51 / $2,987.43
| Professional | | $686.47 | $912.51 | $2,987.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $9,270.00 / $17,192.00
| Facility | | $5,121.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.35 / $882.35 / $1,367.27
| Professional | | $531.35 | $882.35 | $1,367.27 |