- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.00 / $2,594.00 / $7,542.00
| Facility | | $696.00 | $2,594.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.47 / $600.86 / $1,015.52
| Professional | | $526.47 | $600.86 | $1,015.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,518.44 / $4,352.55 / $8,431.35
| Facility | | $2,518.44 | $4,352.55 | $8,431.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $547.58 / $693.10 / $944.47
| Professional | | $547.58 | $693.10 | $944.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $545.54 / $553.40
| Facility | | $80.00 | $545.54 | $553.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.41 / $674.41 / $674.41
| Facility | | $674.41 | $674.41 | $674.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.04 / $781.98 / $1,205.50
| Professional | | $589.04 | $781.98 | $1,205.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.23 / $11,500.00 / $16,394.00
| Facility | | $2,226.23 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,126.39 / $6,452.47 / $6,665.40
| Professional | | $5,126.39 | $6,452.47 | $6,665.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.67 / $769.45 / $1,240.53
| Facility | | $578.67 | $769.45 | $1,240.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $733.05 / $879.66 / $1,090.78
| Professional | | $733.05 | $879.66 | $1,090.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $949.70 / $949.70 / $949.70
| Professional | | $949.70 | $949.70 | $949.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.67 / $772.11 / $1,274.00
| Facility | | $578.67 | $772.11 | $1,274.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.50 / $802.75 / $1,235.21
| Professional | | $598.50 | $802.75 | $1,235.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,425.00 / $10,600.00
| Facility | | $1,634.00 | $4,425.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.85 / $626.65 / $990.62
| Professional | | $460.85 | $626.65 | $990.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.51 / $567.33 / $789.67
| Professional | | $500.51 | $567.33 | $789.67 |