- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.00 / $3,174.00 / $10,836.00
| Facility | | $514.00 | $3,174.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.70 / $346.30 / $527.00
| Professional | | $226.70 | $346.30 | $527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,834.09 / $4,243.05 / $7,336.37
| Facility | | $1,834.09 | $4,243.05 | $7,336.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.27 / $358.90 / $522.80
| Professional | | $229.27 | $358.90 | $522.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.62 / $4,338.04 / $4,338.04
| Facility | | $232.62 | $4,338.04 | $4,338.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.74 / $425.74 / $425.74
| Facility | | $425.74 | $425.74 | $425.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.42 / $419.57 / $671.50
| Professional | | $267.42 | $419.57 | $671.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.92 / $11,500.00 / $26,542.00
| Facility | | $1,191.92 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,849.76 / $2,804.16 / $3,246.98
| Professional | | $1,849.76 | $2,804.16 | $3,246.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.81 / $391.86 / $603.52
| Facility | | $257.81 | $391.86 | $603.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.67 / $459.05 / $677.14
| Professional | | $314.67 | $459.05 | $677.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.32 / $423.90 / $906.70
| Professional | | $258.32 | $423.90 | $906.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.89 / $393.27 / $615.04
| Facility | | $258.89 | $393.27 | $615.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.85 / $443.99 / $744.29
| Professional | | $271.85 | $443.99 | $744.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.95 / $411.72 / $639.16
| Professional | | $308.95 | $411.72 | $639.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.07 / $361.84 / $509.83
| Professional | | $321.07 | $361.84 | $509.83 |