- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.28 / $1,486.00 / $3,398.55
| Facility | | $520.28 | $1,486.00 | $3,398.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.53 / $500.96 / $945.70
| Professional | | $332.53 | $500.96 | $945.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $853.60 / $2,854.00 / $9,039.00
| Facility | | $853.60 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.40 / $859.04 / $3,733.20
| Professional | | $401.40 | $859.04 | $3,733.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.69 / $553.44 / $988.00
| Facility | | $430.69 | $553.44 | $988.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.17 / $849.46 / $1,351.00
| Professional | | $589.17 | $849.46 | $1,351.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.67 / $756.44 / $1,459.32
| Professional | | $454.67 | $756.44 | $1,459.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.43 / $785.32 / $6,679.00
| Facility | | $364.43 | $785.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $594.61 / $721.80 / $996.37
| Professional | | $594.61 | $721.80 | $996.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.66 / $989.34 / $1,486.43
| Professional | | $472.66 | $989.34 | $1,486.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,551.75 / $5,551.75 / $5,551.75
| Facility | | $5,551.75 | $5,551.75 | $5,551.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.52 / $397.64 / $600.00
| Professional | | $273.52 | $397.64 | $600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,844.33 / $3,764.00 / $16,394.00
| Facility | | $1,844.33 | $3,764.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.37 / $1,089.84 / $3,733.20
| Professional | | $567.37 | $1,089.84 | $3,733.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.16 / $824.15 / $1,554.70
| Professional | | $517.16 | $824.15 | $1,554.70 |