- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $961.00 / $2,747.00 / $5,454.00
| Facility | | $961.00 | $2,747.00 | $5,454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.04 / $466.26 / $840.44
| Professional | | $300.04 | $466.26 | $840.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $779.38 / $2,854.00 / $9,039.00
| Facility | | $779.38 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.96 / $808.42 / $3,565.68
| Professional | | $379.96 | $808.42 | $3,565.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.82 / $504.77 / $901.13
| Facility | | $392.82 | $504.77 | $901.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.84 / $761.35 / $1,093.93
| Professional | | $511.84 | $761.35 | $1,093.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.88 / $698.94 / $1,320.43
| Professional | | $416.88 | $698.94 | $1,320.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.82 / $716.26 / $6,679.00
| Facility | | $331.82 | $716.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $569.79 / $693.57 / $957.40
| Professional | | $569.79 | $693.57 | $957.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.08 / $903.99 / $1,416.75
| Professional | | $430.08 | $903.99 | $1,416.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,115.38 / $4,501.87 / $4,837.07
| Facility | | $4,115.38 | $4,501.87 | $4,837.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $824.72 / $997.46 / $997.46
| Professional | | $824.72 | $997.46 | $997.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.02 / $3,764.00 / $26,542.00
| Facility | | $1,682.02 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.22 / $1,031.11 / $3,565.68
| Professional | | $514.22 | $1,031.11 | $3,565.68 |
- 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
- $513.91 / $759.17 / $1,585.93
| Professional | | $513.91 | $759.17 | $1,585.93 |