- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.50 / $2,618.00 / $3,625.00
| Facility | | $388.50 | $2,618.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.82 / $362.36 / $692.77
| Professional | | $245.82 | $362.36 | $692.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $619.76 / $2,376.00 / $8,498.00
| Facility | | $619.76 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.52 / $644.16 / $2,755.76
| Professional | | $294.52 | $644.16 | $2,755.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.66 / $400.48 / $714.95
| Facility | | $311.66 | $400.48 | $714.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.68 / $584.64 / $951.50
| Professional | | $397.68 | $584.64 | $951.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.32 / $555.23 / $1,069.49
| Professional | | $310.32 | $555.23 | $1,069.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.14 / $568.28 / $6,679.00
| Facility | | $269.14 | $568.28 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.64 / $532.59 / $735.19
| Professional | | $438.64 | $532.59 | $735.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.91 / $715.67 / $1,098.83
| Professional | | $341.91 | $715.67 | $1,098.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,329.80 / $3,217.80 / $5,308.67
| Facility | | $2,329.80 | $3,217.80 | $5,308.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.86 / $293.86 / $740.15
| Professional | | $293.86 | $293.86 | $740.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.75 / $3,372.00 / $16,394.00
| Facility | | $1,335.75 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.33 / $799.80 / $2,755.76
| Professional | | $389.33 | $799.80 | $2,755.76 |
- 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
- $388.01 / $584.80 / $1,150.76
| Professional | | $388.01 | $584.80 | $1,150.76 |