- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.56 / $2,663.12 / $3,808.44
| Facility | | $429.56 | $2,663.12 | $3,808.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.73 / $460.29 / $1,225.51
| Professional | | $284.73 | $460.29 | $1,225.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $733.46 / $2,376.00 / $8,498.00
| Facility | | $733.46 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.22 / $777.57 / $3,903.64
| Professional | | $379.22 | $777.57 | $3,903.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.30 / $473.27 / $844.88
| Facility | | $368.30 | $473.27 | $844.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.83 / $735.13 / $1,171.69
| Professional | | $503.83 | $735.13 | $1,171.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.70 / $674.04 / $1,256.52
| Professional | | $392.70 | $674.04 | $1,256.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.68 / $671.56 / $6,679.00
| Facility | | $309.68 | $671.56 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.17 / $681.00 / $941.92
| Professional | | $558.17 | $681.00 | $941.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.41 / $848.24 / $1,402.42
| Professional | | $403.41 | $848.24 | $1,402.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,484.69 / $3,103.34 / $3,298.77
| Facility | | $2,484.69 | $3,103.34 | $3,298.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.68 / $815.91 / $1,631.82
| Professional | | $486.68 | $815.91 | $1,631.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,568.69 / $3,372.00 / $16,394.00
| Facility | | $1,568.69 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.19 / $1,048.34 / $3,903.64
| Professional | | $540.19 | $1,048.34 | $3,903.64 |
- 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
- $510.13 / $776.19 / $2,073.08
| Professional | | $510.13 | $776.19 | $2,073.08 |