- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.53 / $2,671.00 / $4,712.00
| Facility | | $462.53 | $2,671.00 | $4,712.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.66 / $457.39 / $809.05
| Professional | | $292.66 | $457.39 | $809.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $769.86 / $2,854.00 / $9,039.00
| Facility | | $769.86 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.22 / $786.92 / $3,475.20
| Professional | | $368.22 | $786.92 | $3,475.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.59 / $495.48 / $884.54
| Facility | | $385.59 | $495.48 | $884.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.49 / $769.64 / $1,267.65
| Professional | | $527.49 | $769.64 | $1,267.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.34 / $686.42 / $1,289.79
| Professional | | $399.34 | $686.42 | $1,289.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.27 / $703.08 / $6,679.00
| Facility | | $325.27 | $703.08 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.00 / $677.27 / $934.89
| Professional | | $556.00 | $677.27 | $934.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.48 / $886.23 / $1,390.97
| Professional | | $421.48 | $886.23 | $1,390.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,106.62 / $7,106.62 / $13,558.78
| Facility | | $7,106.62 | $7,106.62 | $13,558.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $837.79 / $837.79 / $837.79
| Professional | | $837.79 | $837.79 | $837.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.72 / $3,764.00 / $26,542.00
| Facility | | $1,650.72 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.08 / $998.85 / $3,475.20
| Professional | | $487.08 | $998.85 | $3,475.20 |
- 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
- $460.75 / $739.13 / $1,462.35
| Professional | | $460.75 | $739.13 | $1,462.35 |