- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.93 / $2,663.12 / $3,693.00
| Facility | | $455.93 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.22 / $443.02 / $884.16
| Professional | | $293.22 | $443.02 | $884.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.64 / $2,376.00 / $8,498.00
| Facility | | $735.64 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.09 / $767.23 / $3,315.60
| Professional | | $351.09 | $767.23 | $3,315.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.01 / $478.03 / $853.39
| Facility | | $372.01 | $478.03 | $853.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.40 / $754.08 / $1,199.31
| Professional | | $510.40 | $754.08 | $1,199.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.58 / $662.90 / $1,270.43
| Professional | | $393.58 | $662.90 | $1,270.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.12 / $678.32 / $6,679.00
| Facility | | $315.12 | $678.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.79 / $640.75 / $884.49
| Professional | | $527.79 | $640.75 | $884.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.58 / $855.21 / $1,313.64
| Professional | | $408.58 | $855.21 | $1,313.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,863.50 / $3,863.50 / $7,072.60
| Facility | | $3,863.50 | $3,863.50 | $7,072.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.25 / $596.90 / $719.62
| Professional | | $398.25 | $596.90 | $719.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,594.01 / $3,372.00 / $16,394.00
| Facility | | $1,594.01 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.79 / $983.11 / $3,315.60
| Professional | | $514.79 | $983.11 | $3,315.60 |
- 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
- $487.21 / $720.65 / $1,375.54
| Professional | | $487.21 | $720.65 | $1,375.54 |