- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.51 / $2,718.44 / $8,061.71
| Facility | | $409.51 | $2,718.44 | $8,061.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.26 / $433.10 / $833.47
| Professional | | $376.26 | $433.10 | $833.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.29 / $570.29 / $570.29
| Professional | | $570.29 | $570.29 | $570.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.90 / $701.54 / $1,169.85
| Professional | | $445.90 | $701.54 | $1,169.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.60 / $624.76 / $1,081.90
| Professional | | $473.60 | $624.76 | $1,081.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.51 / $583.00 / $907.03
| Facility | | $409.51 | $583.00 | $907.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $528.74 / $535.00 / $606.00
| Professional | | $528.74 | $535.00 | $606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $562.00 / $1,151.90
| Professional | | $3.00 | $562.00 | $1,151.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.76 / $504.48 / $1,032.22
| Professional | | $360.76 | $504.48 | $1,032.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,592.52 / $8,957.00 / $26,542.00
| Facility | | $1,592.52 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,345.99 / $3,345.99 / $3,637.88
| Professional | | $3,345.99 | $3,345.99 | $3,637.88 |