- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,663.12 / $4,410.00
| Facility | | $478.63 | $2,663.12 | $4,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.11 / $454.55 / $819.79
| Professional | | $280.11 | $454.55 | $819.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.20 / $2,854.00 / $9,039.00
| Facility | | $746.20 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.78 / $800.35 / $3,477.36
| Professional | | $370.78 | $800.35 | $3,477.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.44 / $483.73 / $863.55
| Facility | | $376.44 | $483.73 | $863.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.83 / $781.75 / $1,265.30
| Professional | | $510.83 | $781.75 | $1,265.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.62 / $668.88 / $1,272.66
| Professional | | $400.62 | $668.88 | $1,272.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.25 / $686.40 / $6,679.00
| Facility | | $318.25 | $686.40 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.40 / $676.02 / $933.17
| Professional | | $555.40 | $676.02 | $933.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.45 / $866.93 / $1,381.41
| Professional | | $412.45 | $866.93 | $1,381.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.83 / $351.98 / $480.36
| Professional | | $237.83 | $351.98 | $480.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,612.48 / $3,764.00 / $26,542.00
| Facility | | $1,612.48 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.16 / $1,019.60 / $3,477.36
| Professional | | $533.16 | $1,019.60 | $3,477.36 |
- 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
- $502.60 / $788.59 / $1,646.12
| Professional | | $502.60 | $788.59 | $1,646.12 |