- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,707.26 / $2,733.00 / $6,343.74
| Facility | | $1,707.26 | $2,733.00 | $6,343.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.26 / $447.88 / $702.26
| Professional | | $376.26 | $447.88 | $702.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.17 / $4,402.00 / $9,401.00
| Facility | | $947.17 | $4,402.00 | $9,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.01 / $786.54 / $3,345.99
| Professional | | $441.01 | $786.54 | $3,345.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.30 / $836.79 / $1,133.63
| Professional | | $510.30 | $836.79 | $1,133.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.36 / $740.47 / $1,219.57
| Professional | | $438.36 | $740.47 | $1,219.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.24 / $930.48 / $6,679.00
| Facility | | $430.24 | $930.48 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.70 / $598.03 / $818.82
| Professional | | $493.70 | $598.03 | $818.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.48 / $1,055.58 / $1,392.49
| Professional | | $532.48 | $1,055.58 | $1,392.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.57 / $329.57 / $570.03
| Professional | | $329.57 | $329.57 | $570.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,592.52 / $5,268.00 / $26,542.00
| Facility | | $1,592.52 | $5,268.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.59 / $806.37 / $3,345.99
| Professional | | $480.59 | $806.37 | $3,345.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.28 / $672.83 / $1,351.43
| Professional | | $449.28 | $672.83 | $1,351.43 |