- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.31 / $2,663.12 / $4,767.00
| Facility | | $437.31 | $2,663.12 | $4,767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.97 / $455.40 / $848.30
| Professional | | $289.97 | $455.40 | $848.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.19 / $2,854.00 / $9,039.00
| Facility | | $755.19 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.04 / $792.31 / $5,618.43
| Professional | | $385.04 | $792.31 | $5,618.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.76 / $487.99 / $871.17
| Facility | | $379.76 | $487.99 | $871.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.71 / $724.79 / $1,140.51
| Professional | | $455.71 | $724.79 | $1,140.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.68 / $678.81 / $1,287.23
| Professional | | $397.68 | $678.81 | $1,287.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.95 / $692.46 / $6,679.00
| Facility | | $318.95 | $692.46 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $573.92 / $700.22 / $969.16
| Professional | | $573.92 | $700.22 | $969.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.88 / $874.47 / $1,444.41
| Professional | | $415.88 | $874.47 | $1,444.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.01 / $3,217.80 / $5,421.11
| Facility | | $221.01 | $3,217.80 | $5,421.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.44 / $839.52 / $1,349.05
| Professional | | $258.44 | $839.52 | $1,349.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.67 / $3,764.00 / $16,394.00
| Facility | | $1,615.67 | $3,764.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.01 / $1,002.25 / $5,618.43
| Professional | | $512.01 | $1,002.25 | $5,618.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.92 / $777.98 / $1,482.96
| Professional | | $485.92 | $777.98 | $1,482.96 |