- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.85 / $2,663.12 / $4,767.00
| Facility | | $640.85 | $2,663.12 | $4,767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.69 / $463.10 / $1,081.57
| Professional | | $309.69 | $463.10 | $1,081.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.54 / $2,575.00 / $6,296.53
| Facility | | $560.54 | $2,575.00 | $6,296.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.69 / $811.56 / $3,463.20
| Professional | | $373.69 | $811.56 | $3,463.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.07 / $517.94 / $924.64
| Facility | | $403.07 | $517.94 | $924.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.20 / $780.95 / $1,195.14
| Professional | | $525.20 | $780.95 | $1,195.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.45 / $699.72 / $1,350.39
| Professional | | $420.45 | $699.72 | $1,350.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.89 / $734.96 / $6,679.00
| Facility | | $340.89 | $734.96 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.05 / $668.97 / $923.44
| Professional | | $551.05 | $668.97 | $923.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.91 / $923.63 / $1,369.01
| Professional | | $439.91 | $923.63 | $1,369.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,859.98 / $1,859.98 / $7,385.63
| Facility | | $1,859.98 | $1,859.98 | $7,385.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.88 / $373.29 / $524.69
| Professional | | $233.88 | $373.29 | $524.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,628.00 / $9,039.00
| Facility | | $55.00 | $2,628.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.44 / $1,000.57 / $3,463.20
| Professional | | $517.44 | $1,000.57 | $3,463.20 |
- 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
- $498.04 / $784.32 / $1,650.17
| Professional | | $498.04 | $784.32 | $1,650.17 |